Health Plans

For health plans, accurate provider data and comprehensive credentialing are vital for compliance and member satisfaction. Our blog offers valuable insights into provider network management, data integrity, and compliance strategies that drive operational excellence. Learn how automation and real-time data validation optimize provider enrollment and monitoring processes. Stay ahead with the latest best practices and industry advancements.

How Healthcare Organizations Can Prepare for Upcoming Compliance Audits

If you’re responsible for compliance in your healthcare organization, you probably don’t need a reminder that audits are coming. What you need is a system to stay ready without the last-minute rush. The truth is, successful audits don’t come from neatly stored...

Reducing Payment Integrity Issues in Health Plan Claims Processing

The complexity of the healthcare system and health plan claims processing leaves room for many errors. Unfortunately, such errors can cause operational inefficiencies, increase administrative burden, and indirectly put patients’ health at risk. As such, health plan...

ROI of Outsourced Medical Credentialing

The rapid growth of the healthcare system places a demand on healthcare facilities to onboard more providers to expedite patient care. This translates to long hours spent on provider verification, credentialing, and paperwork, which can sway admin teams. For...

Understanding Delegated Credentialing

Imagine a relay race where passing the baton smoothly determines the outcome of the entire event. Now, think of credentialing in healthcare as that race—only instead of runners, it's healthcare providers and organizations ensuring qualifications, compliance,...

The Role of AI in Healthcare Compliance

Technologies continue to transform the healthcare industry—the da Vinci® Surgical Robot performs precise movements that enable minimally invasive surgeries, the CyberKnife delivers targeted radiotherapy, and smart devices provide practitioners with instantaneous...

Understanding Delegated Credentialing

Apr 3, 2025

Imagine a relay race where passing the baton smoothly determines the outcome of the entire event. Now, think of...

The Role of AI in Healthcare Compliance

Mar 6, 2025

Technologies continue to transform the healthcare industry—the da Vinci® Surgical Robot performs precise movements...

Preventing Non-Compliance Consequences in Healthcare

Mar 6, 2025

In the healthcare industry, compliance with regulatory standards is not merely a requirement but a cornerstone of...

What is a Healthcare Compliance Audit?

Jan 8, 2024

Healthcare is a high-risk industry; auditing is the systematic and objective process that mitigates risk. Healthcare...

What are Healthcare Provider Voluntary Compliance Programs?

Jan 8, 2024

Compliance with the Office of Inspector General (OIG) is not just best practice but a legal requirements not just best...

Data Compliance: 3 Focus Areas for Mitigating Organizational Risk

May 10, 2023

There is no question that healthcare organizations should have an effective healthcare compliance program. Despite...

Provider Data Challenges for Health Plans

Mar 7, 2022

By Charlie Falcone While leaving her house to visit her grandson, Sue falls and twists her knee. At the emergency...

Five Ways Payers Can Improve Provider Responsiveness

Jan 4, 2022

By Scott Alsup Consider partnering with a Credentials Verification Organization (CVO) to save time and expedite your...

Data Challenges that Health Plans and Providers Must Navigate

Nov 30, 2021

By: Scott Alsup, Senior Vice President of Operations at Verisys How to Maintain Compliance and Data Integrity Despite...

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Is Your Organization Ready for NCQA’s 2025 Compliance Changes?

Learn more about the updated July 1st NCQA requirements and how Verisys can help maintain your compliant status.

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FACIS® Sanction & Exclusion Screening + Monitoring

Industry’s most accurate and trusted exclusion + sanction dataset.

Healthcare Credentialing

Optimize Cred processes to reduce cost, mitigate risk, and speed up time-to-network.

Decisional Data Verification

OFAC, DEA, Abuse Registry, & more: Confirm your organization makes decisions based on accurate, verified provider data.

Provider Data Management

Transform incomplete, flawed provider data into comprehensive, configurable directories.

Automated Licensure with LicenseCheck

Real-time verification and monitoring of providers’ licenses.

Continuous True Monitoring

Continuously monitor credentials, licenses, and regulatory statuses for real-time confirmation of good standing.

Credential & Certification Verification

Ensure regulatory statuses are always current with real-time alerts.

Pre-Hire & Workforce Compliance

Pre-screen medical credentials, sanctions, and licensure history for real-time workforce compliance.

Comprehensive Coverage

Verisys supports all provider and taxonomy types across all jurisdictions, from surgeons to technicians.

Connect with us →

Is Your Organization Ready for NCQA’s 2025 Compliance Changes?

Learn more about the updated July 1st NCQA requirements and how Verisys can help maintain your compliant status.

Learn More

FACIS® Sanction & Exclusion Screening + Monitoring

Industry’s most accurate and trusted exclusion + sanction dataset.

Healthcare Credentialing

Optimize Cred processes to reduce cost, mitigate risk, and speed up time-to-network.

Credential & Certification Verification

Ensure regulatory statuses are always current with real-time alerts.

Provider Data Management

Transform incomplete, flawed provider data into comprehensive, configurable directories.

Automated Licensure with LicenseCheck

Real-time verification and monitoring of providers’ licenses.

Continuous True Monitoring

Continuously monitor credentials, licenses, and regulatory statuses for real-time confirmation of good standing.

Decisional Data Verification

Confirm your organization makes decisions based on accurate, verified provider data.

Pre-Hire & Workforce Compliance

Pre-screen medical credentials, sanctions, & license history for real-time workforce compliance.

Comprehensive Coverage

Verisys supports all provider and taxonomy types across all jurisdictions, from surgeons to technicians.

Connect With Us

How Negligent Credentialing Increases Medical Malpractice Exposure

Negligent credentialing exposes healthcare organizations to direct legal liability beyond any individual physician's malpractice. When a facility...

Why Provider Eligibility Matters in Workers’ Compensation Claims

Provider eligibility in workers’ compensation is not just a credentialing requirement. It directly determines whether a claim can be paid. When...

What Healthcare Organizations Look for in a Compliance Data Provider

Healthcare organizations face many complexities in compliance monitoring: more regulations, more provider types, more data sources, and higher...

The Benefits of Continuous Background Checks in Healthcare Staffing

A background check confirms who a provider is at the moment of hire, but it does not confirm who they remain over time. In the healthcare industry,...

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February 2026 Legislative and Compliance Healthcare Updates

This month’s compliance landscape features a major federal fraud enforcement action, a state-level government audit revealing critical data privacy failures, multi-state provider license revocations, and a reminder of the New Jersey Board of Pharmacy’s robust oversi...

Health Plans

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Is Your Organization Ready for NCQA’s 2025 Compliance Changes?

Is Your Organization Ready for NCQA’s 2025 Compliance Changes?

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February 2026 Legislative and Compliance Healthcare Updates