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 When that information is incomplete or outdated, healthcare...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...

Closing the DMEPOS Screening Gap in Medicare Advantage: How FACIS Helps MAOs Stay Ahead of Fraud

A HHS Office of Inspector General issue brief (OEI-02-24-00310, September 2026) delivers a clear warning to Medicare Advantage organizations: the screening gaps that let fraudulent durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers bill...

Creating a Single Source of Truth for Provider Data

Healthcare organizations often manage provider information across credentialing platforms, HR systems, provider directories, compliance tools, committees, enrollment systems, and claims workflows. When those systems maintain different versions of the same record,...

How Hospitals Can Reduce Credentialing Delays and Data Gaps

Hospital credentialing verifies a practitioner’s qualifications, including licensure, education, training, sanctions history, and other required information. Privileging is a separate process that authorizes the practitioner to perform specific services at the...
Creating a Single Source of Truth for Provider Data

Creating a Single Source of Truth for Provider Data

Healthcare organizations often manage provider information across credentialing platforms, HR systems, provider directories, compliance tools, committees, enrollment systems, and claims workflows....

Healthcare Credentialing API Integration Guide

Healthcare Credentialing API Integration Guide

Healthcare credentialing and compliance teams often rely on several systems to manage provider information. License data, verification results, and monitoring updates may be stored in different...

Webinars & Compliance Updates

February 2026 Legislative and Compliance Healthcare Updates

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...

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