A large part of establishing privileging guidelines is boiling all the information down to what's most relevant to the unique specifications of the MSP's own facility and then making the best recommendations possible to the departments or service lines, the credentials committee...
Credentialing Resource Center Digest - Volume 15, Issue 47
A jury has convicted a physician and his clinic administrator on 19 counts of healthcare fraud and a charge of conspiracy for billing Medicare $2.1 million for tests that were never performed.
Credentialing Resource Center Digest - Volume 15, Issue 45
The hospital system Dignity Health recently agreed to pay the government $37 million to settle allegations it overbilled Medicare from 2006 to 2010 for inpatient care at a dozen of its hospitals that should have been billed as outpatient procedures.
The results are in for the Agency for Healthcare Research and Quality (AHRQ)'s second Medical Office Survey on Patient Safety Culture. The survey, designed to measure the culture of patient safety in outpatient medical offices, gauges staff and provider attitudes about patient...
Credentialing Resource Center Journal - Volume 23, Issue 11
A difficult recruitment and retention environment—as well as patient, community, and hospital need—provide understandable pressure to quickly get certain practitioners and specialties credentialed and privileged. While CMS is silent regarding the use of temporary privileges or locum...
Credentialing Resource Center Digest - Volume 15, Issue 44
A licensed physician assistant was sentenced to 15 years in prison and ordered to pay more than $85 million in restitutions for participating in a scheme in which he and his co-conspirators claimed $200 million in fraudulent Medicare billings
The North Carolina Court of Appeals (the “Court”), in an unpublished opinion, reversed a county Superior Court order for a hospital to produce peer review information. The Court ruled in a matter related to an orthopedic surgeon’s lawsuit alleging unfair and deceptive trade...
Credentialing Resource Center Journal - Volume 23, Issue 10
Effective October 1, the National Practitioner Data Bank (NPDB) has lowered the rates it charges for information about practitioners and organizations. The new fee to query the NPDB will be $3.00 for both continuous and one-time queries and $5.00 for self-queries.
All other...
Credentialing Resource Center Journal - Volume 23, Issue 9
CMS' 2-midnight rule states that inpatient admissions are considered reasonable and necessary for stays that last at least two midnights. Stays that fall short of that benchmark should be billed as outpatient services.
