Category: General Credentialing

  We’ve added 4 new reports to the CredSimple platform that make staying on top of your continuously changing network easier: Turnaround time, Monthly Monitoring, Primary Source Verification and Credentialing Contacts. Turnaround Time Report  What it is: A real-time high-level view of where your providers are in the credentialing process, provider-specific status details, and network-level turnaround […]

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. […]

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 […]

Compliance-and-tech-startups

CredSimple is an NCQA certified CVO. Getting this certification required a significant investment and over a year of hard work from our amazing team led by Dr. Garry Choy (Chief Medical and Compliance Officer) and Sam Meyer (Chief Technology Officer)! CredSimple, like Zenefits and many other health-tech companies, provides a tech solution to mission-critical business […]

NCQA Certified CVO

CredSimple is now an NCQA Certified CVO NEW YORK, March 1, 2016 /PRNewswire/ — CredSimple, the leading SaaS platform for real-time credentialing of medical providers and facilities, today announced that it has received its Credentials Verification Organization (CVO) certification from NCQA, a private, non-profit organization dedicated to improving healthcare quality. As a certified CVO, CredSimple has […]

NCQA Credentialing Requirements

One of our goals for our blog is to demystify credentialing so we are creating a series especially for leaders and business process owners who want to gain a deeper understanding of the NCQA credentialing guidelines but don’t have time to wade through 100 pages of regulations. In this series, we’ll break down what you need to […]

Centralized_Credentialing

Centralized credentialing can help eliminate repetitive work, improve revenue cycle, and lower credentialing costs for hospitals, facilities and practices. It also improves provider data integrity and facilitates delegation with payers. To take a deeper dive into the benefits of centralized credentialing, let’s take a moment to understand what centralizing means and what tasks should and […]

Founded in 1990 with the mission to systematically improve healthcare quality, NCQA is considered the gold standard when it comes to credentialing requirements. We think it’s important to understand and get the most out of the NCQA credentialing requirements. In this post, we’ll explore the six common mistakes we’ve seen healthcare organizations make as they endeavor […]

Today marks the long-awaited next chapter in science fiction with the release of Star Wars: The Force Awakens. The names Han Solo, Luke Skywalker and Princess Leia shaped countless childhoods through multiple generations. So, today on the blog, we look back on some of CredSimple’s favorite Star Wars quotes, the lessons our heroes learned and […]

  Because Anthem Blue Cross and Blue Shield of California had inaccurate data in their provider directories, they overstated their physician networks during the Affordable Care Act coverage rollout in 2014. As a result, these insurers will have to pay out millions in refunds to members who incurred out-of-network costs because they relied on poor […]