Wednesday, June 28, 2017

Free Resource

Regulatory and accreditation body verification requirements for managed care credentialing

The purpose of the verification process is to ensure that the information provided by the applicant is accurate and to determine whether the applicant’s credentials meet the organization’s criteria, as outlined in its policies. Verifications are performed at both initial credentialing and recredentialing, although only those elements subject to change (e.g., licensure) are required to be reverified at recredentialing. This table summarizes the various credentialing elements that must be verified through an appropriate source (either primary or secondary source accepted) and the associated time frames required by the regulatory and accreditation bodies impacting managed care credentialing.

 

New Content: Members Only

Temper the use of temporary privileges, part 2
 Published 6/28/17

These three cultural shortcomings can fuel abusive temporary privileging practices.

Sample temporary privileging policy
 Published 6/28/17

Bylaws and policies that don’t sufficiently address temporary privileges—or that leave the door open for corner-cutting—jeopardize organizations’ legal standing and patients’ access to quality care.

New Platinum Plus webinar: Telemedicine credentialing, privileging, and competence assessment
 Published 6/28/17

"Telemedicine: Performing Effective Credentialing, Privileging, and Peer Review for Remote Practitioners" is now available to Platinum Plus members of the Credentialing Resource Center (CRC)! Click here to access this new release directly through the CRC website.

Check out the four webinars released last month for Platinum Plus members:

Four major time-savers for MSPs on the go
 Published 6/26/17 
To: MSP colleagues
From: Me
Subject: Help!

How many of us have received and/or sent an email that started out like this? We all have, at one time or another, and the person asking is hanging out there, swinging by a rope, hoping to latch on to someone who has the answers and the time to provide them. The operative word here is “time,” a seriously valuable (and too often scarce) commodity in our chosen profession. That person with the solution might be unable to lend a hand, already juggling the load of multiple positions, all while contending with antiquated or absent tools. How do we save time and produce more with what we have (or don’t have)?

 

CRC Announcements

Last week! Take the 2017 MSP Salary Survey

Click here to share your professional experiences before the survey closes this Friday.

Take our poll: Bylaws and peer review commitees

Do your bylaws define "peer review committee"? Take our new poll and let us know. You must be signed in with your free or paid CRC account to participate.

For more information about bylaws, register for our webinar, Writing Medical Staff Bylaws: How to Avoid Compliance Gaps and Implement Best Practices presented by Michael R. Callahan, JD, on Wednesday, July 19, at 1 p.m. Eastern.

Call for submissions: Specialty-specific performance indicators

Send us your best performance indicators, and if they’re selected for publication, we’ll send you a complimentary book.

Let your next career find you: HCPro Career Center

Searching for the right job can be time-consuming. Your time is valuable. Upload your resume to the HCPro Career Center and let the right job come to you!

Visit jobs.hcpro.com

For questions, call or email Susan: 978-624-4594 or [email protected].

 

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Product Spotlight

Credentialing for Managed Care: Compliant Processes for Health Plans and Delegated Entities

New to managed care credentialing? Whether you work for a health plan or a hospital medical staff services department, Credentialing for Managed Care: Compliant Processes for Health Plans and Delegated Entities answers all of your health plan credentialing and enrollment questions. Learn the regulatory and accreditation requirements related to managed care credentialing, including those from CMS, NCQA, and URAC.

Author Amy M. Niehaus, CPMSM, CPCS, MBA, provides readers with the guidance to create a comprehensive and compliant credentialing program to support your health plan or to streamline your hospital’s provider enrollment process through delegation. MSPs in all healthcare environments can benefit from understanding credentialing in the managed care world to support their organizational goals of compliance, operational efficiency, cost savings, and practitioner satisfaction.

 

Contact Us

Delaney Rebernik
Editor
Credentialing Resource Center
[email protected]

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800-650-6787
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For advertising and marketing opportunities with the Credentialing Resource Center, please email [email protected].

 

 

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