Healthcare Compliance Resources

Single source for healthcare compliance best practices, regulatory updates, and industry news.

The Role of Credentialing Data in Payment Integrity: What Healthcare Plans Miss

Credentialing is the foundation of payment integrity. Every reimbursement decision depends on accurate provider data, from licensure and enrollment to sanctions screening and credentialing status. When that information is incomplete or outdated, healthcare...

The Healthcare Payment Integrity Process

Healthcare payment integrity depends on one thing above all else, and that’s trusted provider data. Health plans use analytics and audits to catch improper payments after the fact; accurate, continuously monitored provider data prevents many of those payments before...

The Importance of Healthcare Sanction Screening for Workforce Integrity

The healthcare sanctions background check process remains one of the most critical operations for direct care organizations in 2025. For health systems, pharmacies, health plans, and other entities, healthcare sanction screening supports compliance efforts and ensures...

Credentialing Requirements by State: A Guide for Healthcare Providers

A healthcare provider’s credentials refer to their education, training, and the licenses or certifications they’ve earned before or during their career. ‘Credentialling’ is a little different, referring to the formal process—often conducted by a government agency or...

Ensuring Provider Directory Accuracy for Improved Patient Access

Patients normally research networks and providers before they enroll in a new healthcare plan or seek medical care from a new specialist. However, a 2023 study found over 80% of provider directory listings across five payers demonstrated inconsistencies or...

Credentialing Requirements by State: A Guide for Healthcare Providers

Oct 17, 2025

A healthcare provider’s credentials refer to their education, training, and the licenses or certifications they’ve earned before or during their career. ‘Credentialling’ is a little different,...

Ensuring Provider Directory Accuracy for Improved Patient Access

Oct 17, 2025

Patients normally research networks and providers before they enroll in a new healthcare plan or seek medical care from a new specialist. However, a 2023 study found over 80% of provider directory...

Trends in Healthcare Compliance Monitoring

Oct 16, 2025

As one of the most heavily regulated industries, healthcare compliance involves adhering to a number of regulations that are enforced at different jurisdictional levels. Laws and regulations range...