Credentialing

Delegated credentialing is more than an operational efficiency—it’s a strategic approach that benefits healthcare organizations, providers, and payers alike. By shifting responsibility for the credentialing process to trusted organizations, payers streamline workflows while maintaining oversight through rigorous standards. For Provider Lifecycle Professionals (PLPs), delegated credentialing represents an opportunity to demonstrate their expertise while enhancing the

Trust forms the foundation of healthcare. When patients enter a medical facility, they’re placing their well-being, and sometimes their lives, in the hands of professionals they may have never met before. They trust that these professionals are skilled, licensed, and competent. In this complex environment, credentialing—verifying and vetting healthcare practitioners’ qualifications—plays a critical role in

Delegated credentialing can feel intimidating to both new and seasoned MSPs in managed care, hospital, or CVO environments. But the intimidation is replaced with confidence once you understand the foundations of the delegated credentialing process. Here are the six steps necessary for successful delegated credentialing: Facility contract: The group or facility must have an existing

When I was a newbie, I learned a central lesson about credentialing: that to ensure compliance with the standards, the primary source verification documents I obtained for a practitioner were for my facility only, and peer review information was confidential. That changed when shared services agreements began to take hold. Over the years, four trends

Medical Service Professionals often have Type A personalities. We’re highly organized and proactive – and at times impatient and a bit anxious. It’s understandable that the possibility of losing control over our credentialing process can trigger negative reactions. After all, each hospital and health plan has its own application, its own credentialing process, and its

In August and September, Team Med Global’s Donna Goestenkors, CPMSM®, EMSP, and Rachelle Silva, BS, CPCS®, CPMSM®, joined forces with symplr to present “Off the Hook: Reining in Telemedicine Challenges.” Given that COVID-19 has led to an exponential increase in the use of telemedicine around the U.S., it’s no surprise that the more than 1,000

Hospital credentialing policies outline the application and privileging requirements and criteria and procedures. Credentialing processes explain how information is gathered to provide information for review and decision making by department chairs, committees, and the governing body. The five best practices listed below - claims history, professional references, performance evaluations, onboarding, and internet and social media