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MEDICAL STAFF BYLAWS – PREVENTION IS THE CURE

How Medical Credentialing Bylaws Set the Stage for Transparency in Provider Population Background and Current Behavior A health care organization’s bylaws add a structure of guidance to the hiring practices of providers, leadership, and even the board and vendors. Bylaws arm the human resources staff, the medical staff services professionals, credentialing committees, the medical executive…

Alyssa Rodriguez Employee Spotlight

Alyssa Rodriguez is a Verisys Production Analyst. Alyssa is proficient in multiple Verisys Products: Sanctions, License Verifications, Verified License Searches, and CheckMedic. She also helps with Data Entry and monitoring our clients’ Medpasses. She’s been married to her amazing husband for 10 years, and they have two awesome boys. A lot of their house is…

Vulnerabilities in Government Healthcare Programs

Medicare and Medicaid Management: A Guide to Protect Against Fraud In 1965, President Lyndon B. Johnson created the federally funded, health-related Medicare and Medicaid programs to aid vulnerable U.S. citizens. These programs are now the largest payers of inpatient hospital services, mental health services, long-term care services, and births. While both are federally funded, health-related…

The EPLS to SAM.gov Transition and What It Means for Healthcare Providers

What is the Excluded Parties List System (EPLS)? The Excluded Parties List System (EPLS) is a government database that lists people, vendors, and suppliers prohibited from receiving federal assistance, contracts, or subcontracts from the U.S. government. The EPLS is maintained by the General Services Administration (GSA), a federal agency. Healthcare entities who hire or contract…

HOW THE CREDENTIALS COMMITTEE PROTECTS A HOSPITAL’S REPUTATION

A GOOD REPUTATION IS BUILT OVER TIME AND LOST IN A DAY The Credentials Committee plays a key role in the reputation of a health care system or a single hospital. There is much more in play than medical competence. Yet, that set of criteria carries the most weight when hiring a provider at a…

McKenzie Uribe-Forbes Employee Spotlight

McKenzie Uribe-Forbes is a Verisys Compliance Coordinator. She resolves disputes and conducts legislative research. She and her team closely monitor the federal and state modifications due to COVID-19 and share updates on the Verisys website daily. McKenzie graduated from the University of Utah in Political Science with a minor in Campaign Management. She was fortunate…

What Is a Medical Sanction?

A medical sanction, also known as a healthcare sanction, is a disciplinary action levied against an individual or entity by a state licensing board. A sanction can severely damage an organization’s finances, operations, and reputation, and inhibit providers or entities from participating in federal healthcare programs. The U.S. Department of Health & Human Services (HHS)…

Part 2 of 2: Measuring the Effectiveness of Your Healthcare Compliance Plan

In the second part of our two-part series, we covered three ways to measure your healthcare compliance program’s effectiveness. In this, the second part of the document, we will discuss four more categories to measure healthcare compliance effectiveness. 8 Things to Review in Your Monitoring, Auditing, and Internal Reporting Systems Reporting System: Review and audit…

CMS Preclusion List FAQs

What is the CMS Preclusion List? The Centers for Medicare and Medicaid (CMS) defines the CMS Preclusion List as a record of providers and prescribers who are precluded from receiving payment for Medicare Advantage (MA) items and services or Part D drugs furnished or prescribed to Medicare beneficiaries. In 2018, the Center for Medicare and…

Mohammed Mushib Employee Spotlight

This is Mohammed Mushib and he’s a Verisys Production Analyst. Mohammed has been with Verisys for over nine years and is dedicated to meeting the needs of our customers. He processes the batches from our clients to ensure all health care providers and entities are properly credentialed and he reviews Medpasses to ensure the license…