With integrated departments, onboarding of employed practitioners includes credentialing and privileging, but now ends after successfully enrolling practitioners with commercial insurers, Medicare, and Medicaid.
While CMS survey-and-certification memo 17-44-Hospitals notes that surveyors will start with the average daily census (ADC) and average length of stay, it notes the following as other factors that the CMS regional office may consider when determining whether to conduct a second survey or...
Amy Niehaus, CPMSM, CPCS, MBA, answers the question: At what point in the medical staff credentialing process can an application for enrollment be submitted to the payers?
All accrediting and regulatory bodies require policies and procedures that describe the credentialing program of an MCO or health plan. Policies and procedures provide the framework under which MSPs and credentialing specialists perform their work. They also define the credentialing and...
At its most basic, credentialing is the verification of healthcare practitioners’ education, training, and current competency. Depending on the specific items that need to be verified, this process can be lengthy.
This week’s quick tip comes from a Q&A with Melissa Brenner, medical staff and provider enrollment manager for Adena Health System in Chillicothe, Ohio. About five years ago, the system developed a multidisciplinary provider onboarding team that meets on a biweekly basis to help streamline...
