As healthcare organizations continue to search for ways to reduce costs while maintaining quality, the credentialing and enrollment departments are coming to the forefront as ideal candidates for integration. Although both perform unique and distinct functions, there is significant overlap with...
Credentialing Resource Center Journal - Volume 28, Issue 10
A California Court of Appeals for Division Seven of the Second Appellate District reversed and remanded with directions a trial court’s decision, finding that the terms of an agreement between a physician and hospital cannot be enforced when they conflict with a state-mandated procedure.
Credentialing Resource Center Journal - Volume 28, Issue 8
Last time, we reviewed tips and tools for initiating a provider onboarding and credentialing consolidation project. A key consideration for leading a project of this magnitude and complexity is transparency among stakeholders and involved teams. Interdependence is always part of a large...
Credentialing Resource Center Journal - Volume 27, Issue 11
The United States District Court for the Southern District of Ohio Western Division (the “Court”) denied a hospital’s motion to dismiss a claim of negligent credentialing of an independent surgeon facing multiple federal charges. The motion to dismiss the negligent credentialing claim is one...
Credentialing Resource Center Journal - Volume 27, Issue 7
In managed care credentialing, delegation is defined as a formal process by which an organization gives another entity the authority and responsibility to perform certain functions on its behalf through a contractual arrangement. Delegation can provide many benefits to both organizations, but...
Credentialing Resource Center Journal - Volume 27, Issue 6
The difference between being accredited as a hospital or as an outpatient center can mean a difference of thousands of dollars in revenue when billing Medicare. And if you are a smaller, specialty hospital or an outlying facility that is part of a larger health system, be prepared: CMS and other...
