CredSimple Blog

State-by-State Series, Part I: The Outliers – Illinois & New Mexico

State-by-State Series, Part I: The Outliers – Illinois & New Mexico

As an industry-leading  NCQA CVO, CredSimple follows not only NCQA CVO standards, but also follows state-specific guidelines to help keep our customers in compliance with all regulations.  Credentialing guidelines are…

What Does It Take to Become NCQA Certified as a CVO?

What Does It Take to Become NCQA Certified as a CVO?

Whether you are a CVO looking to achieve certification, or a company in need of credentialing who wants to be compliant with NCQA, it’s important to know exactly what it…

Healthcare Policy News: What’s Going On in Washington

Healthcare Policy News: What’s Going On in Washington

The year is winding down and impeachment is dominating the headlines- but there is still a lot of important healthcare policy news coming out of Washington D.C. and state governments.…

From the CEO: What We Learned From CredSimple’s Inaugural Product Advisory Council

From the CEO: What We Learned From CredSimple’s Inaugural Product Advisory Council

Just over a month ago, we hosted our first Product Advisory Council (PAC) User Forum, which brought together a diverse group of our clients here in New York to share…

Blockchain and Healthcare: Recent Developments

Blockchain and Healthcare: Recent Developments

Blockchain technology stands to revolutionize any number of industries, and healthcare is no exception. Right now, we’re seeing several startups present innovative ideas about how blockchain can make healthcare better.…

Breaking It Down: What is credentialing?

Breaking It Down: What is credentialing?

  1.What is Managed Care/Health Plan Credentialing? Credentialing is the process of obtaining, verifying and assessing the qualifications of a practitioner/provider to provide care or services in or for a…

7 Steps to Get Your Credentialing Committee Up & Running

7 Steps to Get Your Credentialing Committee Up & Running

Perhaps you're part of a team helping to start up a new health plan, or maybe you're new to your role and wondering where to start with the task of…

Peer Review Committee Q&A – What You Need to Know

Peer Review Committee Q&A – What You Need to Know

The goal of the Peer Review Committee (PRC) is to ensure an objective review of care and conduct performed by other practitioners, in order to enhance the quality of patient…

News Roundup: Healthcare Startups & Investments

News Roundup: Healthcare Startups & Investments

With healthcare spending accounting for nearly one-fifth of GDP in the U.S., it’s not surprising that many companies are moving into this space. Over the past few years, we’ve seen…

3 Things to Know About a Typical Credentialing Committee

3 Things to Know About a Typical Credentialing Committee

What is a credentialing committee, and what is it comprised of? A Credentialing Committee is a body of practitioners responsible for 1) accepting and denying providers into a plan’s provider…