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Resources from the Verisys Blog
How Health Plans Can Meet 2026 Network Adequacy Requirements
Medicaid certification for network adequacy is entering a new era of regulation. Beginning in 2026, health plans face stricter federal standards, independent validation requirements, and continuous monitoring expectations that change how organizations demonstrate...
FACIS vs Other Healthcare Exclusion Databases
For healthcare compliance leaders, exclusion screening is not a routine administrative task; it is one of the most scrutinized elements of regulatory oversight. Civil monetary penalties, repayment exposure, audit findings, and reputational risk often trace back to one...
The Importance of Exclusion Screening in Healthcare
Healthcare organizations that employ or contract with excluded individuals face severe civil monetary penalties, repayment of all associated claims, and potential loss of Medicare and Medicaid participation. The stakes are clear: exclusion screening is not optional...
Market vs Verisys for Eligibility & Payment Integrity
Why Eligibility and Payment Integrity Matter More Than Ever Every improper payment tells a story, not just about a claim, but about the controls behind it. For health plans, eligibility and payment integrity are no longer back-office functions. They are board-level...
Physician Onboarding Checklist
Hiring a new practitioner is a complex process for many healthcare entities. A physician onboarding checklist can help guide this process by clearly outlining the key steps required to onboard a new provider. For a physician or nurse signing on as a new provider,...
What Is Human Capital Management As It Relates To Healthcare?
Human Capital Management (HCM) in the healthcare industry is the strategic approach to recruiting, managing, developing, and retaining healthcare professionals to support high-quality patient care, operational efficiency, and organizational performance. In a complex...
Healthcare Exclusion Monitoring – Why It Is So Important to Healthcare Compliance?
Healthcare exclusion monitoring is critical to healthcare compliance because employing or contracting with an excluded provider can result in severe financial penalties, loss of federal program eligibility, and reputational damage. Federal and state exclusion lists...
How To Strengthen Your Pharmacy Compliance and Reduce Risk
What Is Pharmacy Compliance? In essence, pharmacy compliance is an ongoing commitment to abide by all laws, regulations, and professional standards that guide how a pharmacy operates. The goal is to ensure that every prescription is filled accurately, every patient’s...
How to Choose the Right Credentialing Vendor
Choosing the right credentialing verification vendor directly affects whether your healthcare organization can maintain compliance, protect patient safety, and operate efficiently. This is especially important when credentialing fails, organizations face delays in...
How Often Should You Check the OIG Exclusion List?
For healthcare organizations, exclusion screening is not a one-time task, it is an ongoing compliance obligation. The question is not whether you should screen against the OIG exclusion list, but how often you should do it to protect your organization, your patients,...
