– The best resource for monthly healthcare regulatory compliance updates. Compliance Updates: April 2024 Overlook: Licensure Compacts Other Legislation Board Updates Interstate Medical...
Provider Data Challenges for Health Plans
By Charlie Falcone While leaving her house to visit her grandson, Sue falls and twists her knee. At the emergency room, the doctors begin a series of tests to discover what’s wrong with her knee. Unfortunately, Sue’s knee injury is complex. It will take months for her...
Five Ways Payers Can Improve Provider Responsiveness
By Scott Alsup Consider partnering with a Credentials Verification Organization (CVO) to save time and expedite your provider credentialing. It can be difficult for health plans to complete provider credentialing without the help of a CVO. As the largest CVO in the...
Ensuring Provider Directory Compliance With H.R. 133
By Donald Potts and Donovan Schwartz If you have a provider directory, you probably know about the Consolidated Appropriations Act of 2021 (aka H.R. 133). Passed last December, the Act requires group health plans and health insurance issuers to improve the...
What Is the Process of Getting Credentialed with Medical Insurance Companies?
The process of getting credentialed with medical insurance companies is also known as provider enrollment and is the first step of the process for inclusion into payment panels. While the process can be time-intensive, provider enrollment is the only way a healthcare...
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