Medicaid Credentialing
Serve your community and improve access to quality care services by optimizing the Medicaid enrollment application process and streamlining credentialing with other agencies for enhanced data management. Why credential twice instead of once?
State Medicaid & Federal Government
Verisys aligns medical provider enrollment, credentialing and directory services to reduce cost and administrative burden, while increasing provider and member satisfaction. Our healthcare provider data solutions streamline and consolidate siloed departments to deliver tangible results for many provider types.
As a government entity, you’re held to high enrollment and provider eligibility standards. Verisys helps you meet these service requirements as a Credentials Verification Organization with certifications and accreditations from the National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC), International Organization for Standardization (ISO), and American Institute of Certified Public Accountants, Service Organization Trust Criteria (AICPA SOC2).
Verisys delivers streamlined, flexible health form and provider credentialing solutions for 10+ State Medicaid and Federal Departments. Here’s how
- Automate enrollment application processing, credentialing, and onboarding of providers and entity populations with both fee-for-service and managed care entities.
- Automate provider and entity supplier application screening.
- Proactively prevent and mitigate fraud, waste, and abuse through risk-based alerts.
- Meet federal and state health eligibility requirements in developing and maintaining a provider and entity population management system.
- Support the National Fraud Prevention Program (NFPP); 2 42 CFR Part 438, Subpart H; 42 CFR Part 455, Subparts B & E.
- Comply with CMS ACA3 medical provider screening and management requirements.
- Integrate to a State Enterprise Architecture.
- Comply with provider Medicaid Information Technology Architecture (MITA) 3.0 standards.
Optimized Solutions
State Credentialing Alliance
Provider Data & Roster Management
State Credentialing Alliance
Verisys is a leader in Medicaid provider data verification and credentialing, partnering with multiple state consortiums to streamline the process. These collaborations enhance provider satisfaction and reduce credentialing costs by consolidating credentialing into a single, shared event for participating managed care organizations.
Provider Data & Roster Management
Verisys’ provider directory management solutions transform often-flawed provider data into comprehensive, customizable directories that integrate seamlessly with your member portal. We display intricate networks how you want your members to see them, highlighting and tiering network providers just for them — including telemedicine providers.
By offering a more comprehensive, integrated provider search platform, you can keep current members satisfied and engaged while attracting new customers who want to strengthen member engagement. Moreover, by delivering relevant, actionable information, consumers can make informed decisions leading to better outcomes—one of healthcare reform’s primary goals.
Verisys is the top credentialing alliance partner for state Medicaid agencies.
10 Million+
Records in our provider and sanctions database
2 Million+
Credentialing events annually
