CredSimple Blog

Virtual Integration, An Alternative To Consolidation

With virtual integration, organizations can achieve many of the goals of vertical consolidation at a much lower cost. Many industry leaders believe that consolidating hospitals, physician groups and health plans…

Data Portability for Better Patient Outcomes and Experience

Although it may not be immediately apparent to healthcare consumers, blockchain can benefit their healthcare experience and outcomes. An Integrated Care Experience Medical records are fragmented and decentralized, which means…

Blockchain: Beyond the Hype

Blockchain: Beyond the Hype

Blockchain If you’ve heard about blockchain (and who hasn’t recently), you’ve probably heard about it in relation to cryptocurrency, the most prominent example being Bitcoin. That’s because blockchain is the…

NCQA Requirements, Part 5: Ongoing Monitoring

NCQA Requirements, Part 5: Ongoing Monitoring

In this series, we break down what you need to know about credentialing, re-credentialing and delegated credentialing. In prior posts, we covered organizational requirements (CR 1), credentialing committees (CR 2),…

What You Need to Know about NCQA Credentialing Requirements 4 – 8

What You Need to Know about NCQA Credentialing Requirements 4 – 8

In this series, we break down what you need to know about NCQA’s credentialing requirements. Below we cover NCQA credentialing requirements 4 - 8, which ensure that credentialing committees are…

What You Need Know: NCQA Requirements, Part 3: Credentialing Requirements

What You Need Know: NCQA Requirements, Part 3: Credentialing Requirements

In this series, we break down what you need to know about credentialing, re-credentialing and delegated credentialing. Here we cover the establishment of credentialing requirements (CR 3). In prior posts,…

Blockchain Could Make Claims Processing More Accurate and Efficient

Right now, processing insurance claims is an incredibly labor-intensive and error-vulnerable process. Dozens or more people might be involved in manual work related to processing a single claim. That’s because…

What You Need to Know about NCQA CR 2: Credentialing Committee

What You Need to Know about NCQA CR 2: Credentialing Committee

In this series, we break down what you need to know about credentialing, recredentialing and delegated credentialing. In today’s post, we cover the establishment of a credentialing committee (CR 2). In a…

The ABCs of PSVs

The ABCs of PSVs

Have you ever found yourself asking primary source verification (PSV) questions like: "Which verifications need to be checked to ensure a provider is properly credentialed to work at your ambulatory…

Questions to Ask Potential Partners

MarketsandMarkets projects that healthcare’s business process outsourcing (BPO) market will have an annual growth rate of 10.2% through 2021, growing to $276.79 billion. As healthcare organizations are confronted with challenges…