Category: Best Practices

Recredentialing Q&A – What You Need To Know

Recredentialing Q&A – What You Need To Know

Q: How often are practitioners recredentialed? A: Practitioners and facilities are typically recredentialed every three years unless a state or health plan has different requirements. It is important to recredential…

Breaking It Down: Understanding NCQA and CMS Requirements

Breaking It Down: Understanding NCQA and CMS Requirements

CMS vs. NCQA Requirements When it comes to credentialing and compliance, there‚Äôs a lot to keep in mind. One of the most fundamental issues is this: what compliance standards are…

Best Practices for Credentialing Committee Meeting Management

As you probably already know, NCQA requires health plans to meet periodically to make credentialing decisions about network practitioners. During this process, known as a committee meeting, outside experts will…