Category: Credentialing Standards

3 Costly Ways Your Credentialing Operation Affects Your Bottom Line

3 Costly Ways Your Credentialing Operation Affects Your Bottom Line

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…

How to Choose Between NCQA and URAC Accreditation for Credentialing

How to Choose Between NCQA and URAC Accreditation for Credentialing

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…

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. Here we’ll cover NCQA credentialing requirements 4 - 8, which ensure that credentialing committees are…

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),…

Behavioral health provider credentialing requirements are changing. Will you be ready?

Behavioral health provider credentialing requirements are changing. Will you be ready?

There have been several new pieces of legislation passed in New York State that are changing the healthcare regulations. New York’s new regulations—Medicaid Carve-In and Article 31—require behavioral health programs…

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. In today’s post, we cover the establishment of credentialing requirements (CR 3). In…

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…

CredSimple is NCQA Certified for Credentials Verification

CredSimple is NCQA Certified for Credentials Verification

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…

NCQA Credentialing Part 1: Organizational Requirements

NCQA Credentialing Part 1: Organizational 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…

3 Benefits of Centralized Credentialing

3 Benefits of 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.…