Healthcare Credentialing News & Insights

Credentialing nurses and physicians assistants

The increased demand for nurse practitioners (NPs) and physician assistants (PAs) is a nationwide trend that is expected to continue over the coming years. The U.S. Bureau of Labor Statistics expects a growth of around 19% in nurse practitioners alone by 2020 — well above the national average. We’ve seen this trend reflected in an […]

Fact: Your business runs on data. That data affects your business every day. Obsolete provider data is an industry-wide problem. It’s likely that a good portion of your data is already outdated, and another 2% will become outdated every month, making it less useful to you and your members every month. You wouldn’t be okay with your […]

Implementation

Implementation of new technology can seem like a burden, which is why we’ve been purposeful with how we’ve built CredSimple. Our goal is to unburden the credentialing process and to make implementation and use of our platform as efficient as possible. There are 2 distinct but interrelated ways our clients can use our platform: As […]

Your provider credentialing process directly affects your organization’s bottom line in numerous ways. It’s worth considering now whether your credentialing function is a headwind or a tailwind on revenue. Here are 3 ways to mind how it affects your business: #1 — The Accuracy and Usefulness of Your Provider Data Networks and providers are constantly changing. […]

Why is Jessica so Frustrated? Jessica is a busy credentialing coordinator who has been in her role for 5 years. Today, she arrives at her desk to voicemails and emails from the provider relations department requesting status updates on credentialing for their new providers. By lunchtime, she has received more status requests. Every time she […]

Hospital recredentialing tip

With so many moving parts, hospitals — or any other clinical care organizations that employ or work with healthcare providers — must decrease any roadblocks to compliance and revenue cycles. Improving recredentialing efficiency is one way to do so. Cut Out Redundant Affiliation and Privileges Checks When it comes time to recredential providers, organizations can cut […]

We work with a number of health plans and we’ve learned a few tricks that can help reduce provider credentialing turnaround time. Reduced turnaround times increase provider goodwill, help operations improve revenue cycles, and ensure your members have access to the providers they need. The changes include increasing the efficiency of the approval process for […]

Provider credentialing is a necessary business function for health plans and is required in order to ensure quality of care for members. When implementing — or reevaluating —  a credentialing process, there are a few important factors to consider such as cost, employee time and even whether to adhere to NCQA or URAC standards. A […]

The accuracy of provider data starts with credentialing and affects downstream functions and business intelligence. Today most healthcare companies are not able to maximize the value of the credentialing process because the technology underlying the process was not designed for the data needs of the 21st century. Understanding the root of the problem and the […]

In this series, we break down what you need to know about NCQA’s credentialing requirements. Here we’ll cover NCQA credentialing requirements 4 – 8, which ensure that credentialing committees are reviewing all the necessary information about a provider’s credentials and work history so that the committee can make a well-informed decision. In prior posts, we […]