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Healthcare Compliance Annual Review Suggestions

To meet the requirements of increasingly complex healthcare regulations, hospitals and other healthcare entities must ensure the effectiveness of their compliance programs. Before starting your compliance program review, start by becoming familiar with Office of Inspector General (OIG) regulations. Next, it’s time to look at your compliance program. How well does your organization meet these…

Telemedicine Is Here to Stay: How to Navigate Telemedicine and Medical Credentialing

Telemedicine is a rapidly expanding field that has accelerated during the COVID-19 pandemic. Proponents argue that telemedicine significantly increases healthcare access for patients in rural areas, seniors on Medicare (1 in 5 who live outside of a major metropolitan area), socioeconomically vulnerable populations in major urban areas, and the next “on-demand” generation. COVID-19 has brought…

HOSPITAL CLOSURES MAY BRING AN END TO OUTDATED PROVIDER CREDENTIALING PROCESSES

Necessity as the mother of invention will usher in a digital, streamlined process for credentialing health care providers. This blog explores how the trend of hospital closures will ultimately put to bed the old, antiquated, paper processes of credentialing health care providers. Speed, accuracy, interoperability, and portability are the key elements of an effective credentialing…

The Credentialing and Privileging Process

Healthcare organizations are legally responsible for assuring that individuals providing patient care are credentialed, verified, and competent to do so. In order to guarantee compliance and quality patient care, the Centers for Medicare and Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), and Health and Human Services (HHS) require that members of the medical…

EMBRACING CHANGE FOR PROGRESS

Inspiring Physicians to Embrace the Change that Defines Success in Health Care is the topic for Hugh’s Credentialing Digest. He itemizes processes that have roots in the past and then outlines optimal remedies to the traditional conventions that no longer have relevance in the way health care is administered today. By Hugh Greeley, author of…

Irfan Hasovic Employee Spotlight

Say hello to Irfan Hasovic. Irfan is the Director of Technology Implementation at Verisys. He helps lead our IT organization in building and deploying the best technology solutions for our existing and future clients and partners. Irfan grew up in Bosnia during the extremely violent Bosnian War (1992 – 1995). In the city of Srebrenica,…

New Jersey Provider Exclusion Screening

To guard against fraud and abuse and keep patients and healthcare entities safe, the federal government maintains a database of medical providers who have been convicted of fraud and are excluded from participation in government-funded healthcare programs. This database, called the List of Excluded Individuals and Entities (LEIE), can be found on the website of…

What Is a PTAN Number?

Because Medicare is such an expansive system susceptible to fraud, it’s critical that the appropriate measures be taken to identify and authenticate providers. Using the combination of PTAN and NPI numbers in their respective places is critical to stay in compliance and protect the benefits of being involved in the Medicare system. To help you…

10 STEPS TO UNTANGLE CUMBERSOME, BUREAUCRATIC HOSPITAL PROCESSES

Many Processes are an Accumulation of Antiquated Habits, Bylaws, and Regulations This article covers several detailed examples of unnecessary practices, out-of-date requirements, and avoidable time-sucks that can be restructured or eliminated completely from hospital onboarding customs. Chasing down directors and executives for redundant approval signatures is a poor use of time for all involved. Engaging…

Anjana Kanth Employee Spotlight

Anjana Kanth is a Production Team Lead and has worked at Verisys for two years. Anjana helps to improve production processes and double-checks the work of processors on the team to prevent customer disputes and ensure that we meet all quality standards. Anjana really loves food! She enjoys trying new foods and restaurants and has…