– The best resource for monthly healthcare regulatory compliance updates. Compliance Updates: April 2024 Overlook: Licensure Compacts Other Legislation Board Updates Interstate Medical...
State & Federal Government
Serve your community and improve access to quality care by data enhancement and streamlining credentialing with other agencies. Why credential twice instead of once?
State Medicaid & Federal Government
Verisys aligns medical provider credentialing and directory services to reduce cost and administrative burden, while increasing provider and member satisfaction. Our solutions streamline and consolidate siloed departments to deliver tangible results.
As a government entity, you’re held to high standards. Verisys helps you meet them 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 solutions for 10+ State Medicaid and Federal Departments. Here’s why:
- Automate credentialing and onboarding of providers and entity populations with both fee-for-service and managed care entities.
- Automate provider and entity supplier screening.
- Proactively prevent and mitigate fraud, waste, and abuse through risk-based alerts.
- Meet federal and state 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 Medicaid Information Technology Architecture (MITA) 3.0 standards.
Solutions
State Credentialing Alliance
Provider Data & Roster Management
State Credentialing Alliance
Verisys leads the industry in managing state Medicaid credentialing programs in partnership with several state and state-wide consortiums. These alliances improve provider satisfaction while lowering credentialing costs by aligning credentialing to a single, common event, shared by 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
CheckMedic is a SaaS platform that streamlines end-to-end provider credentialing, monitoring, and data management.
VerisysConnect offers an efficient and highly accurate means to perform data inquires and primary source verification for provider credentialing and compliance through its self-serve engine.
Enrollment accelerates and simplifies the application, verification, and attestation process for network providers.
Data Services improves data accuracy, timeliness, and quality by eliminating inaccurate and incomplete provider data.
Provider Directory meets compliance and consumer demands for easy-to-use online, mobile, and printed formats.
Verified License Search and Status, VLSS, assures that the licenses, registrations, and certifications held by a provider are current, in good standing, and in line with credentialing, privileging, and enrollment requirements.
ProviderCheck gives an instant pass/fail status on the five critical data points of a prescriber’s status. Dispense and file claims with certainty.
Network Management strengthens your provider relationship management with a custom Salesforce app.
