May Regulatory Update  – The best resource for monthly updates.   Here is our monthly regulatory update. See below for changes from several states introducing legislation. A big thanks to our compliance team, who monitors state, federal, and international updates.    Arizona:  Legislation to join the APRN Compact has passed the Senate as of 4/26/2023 and is currently being considered in the House. AZ SB1334 Iowa:  Iowa Board of Nursing & Other State Nursing Boards React to the Fake Diploma Scheme The Iowa Board of Nursing has partnered with other board ..read more

  7 Core Elements of Healthcare Compliance  Plan and How to Measure Them Healthcare compliance regulations are complex and ever-changing, but are an essential part of any healthcare organization’s effort to provide safe, high-quality care for patients.   Healthcare entities, especially those that receive funding from Medicaid or Medicare, must meet compliance standards set forth by the Office of Inspector General (OIG). These standards help mitigate an organization’s risk by preventing waste, fraud, and abuse.   An organization’s compliance program ensures that they me ..read more

5 Ways to Improve Your Credentialing Committee Meetings    Planning for Provider Credentialing Committee Meetings Saves Time and Assures a Competent Provider Staff Our work schedules are jam-packed with meetings, leaving little to no time to prepare for them effectively. Any delay in receiving the agenda and relevant material further adds to this challenge. Like most committees, a lack of effective leadership can negatively impact the function of the committee and the organization. In the case of the credentials committee, insufficient preparation of materials and disorganizati ..read more

4 Steps to Becoming an Effective Credentials Chair to Ensure Good Decisions   There is no doubt that being the chair of the credentials committee comes with great responsibility. Ultimately, deciding to appoint a physician to the medical staff falls on your shoulders.  When a credentialing committee doesn’t run effectively, it can jeopardize the quality of patient care and the hospital’s reputation. Below, we will look at a scenario that some credentialing chairs may relate to, as well as ways to improve the function of your credentials committee.    Challenges Facing ..read more

Provider Credentialing: What you Need to Know to Keep Patients Safe   In May every year, thousands of graduating medical students across the United States recite the Hippocratic oath, pledging, “First, do no harm.”  While it is hard to believe those graduating with a professional degree plan to intentionally harm future patients, unfortunately, it can happen.   Harm isn’t just in the form of medical errors but can also be associated with healthcare fraud. In both cases, the patient is the one that may suffer. Let’s look at these two types of harm in healthcare and wha ..read more

April Regulatory Update  – The best resource for monthly updates.     Here is our monthly regulatory update. See below for changes from several states introducing legislation. A big thanks to our compliance team, who monitors state, federal, and international updates.    The Fair Credit Reporting Act summary of rights:  On March 20th, the Consumer Financial Protection Bureau (CFPB) updated the FCRA Summary of Consumer Rights. There were no substantive changes to the consumer rights. The Bureau updated the contact information for federal agencies listed in ..read more

How Primary Source Verification and Monitoring Keep Your Patients Safe Have you heard the story of Dr. Death? Former surgeon Christopher Duntsch, known as Dr. Death, was sentenced in 2017 to life in prison for maiming or killing 33 out of the 37 patients he operated on over a two-year period.  As you learn more about his story, you may ask how something like this could happen. While we can’t change the past, we can learn from it to prevent future events like this from happening. The Importance of Primary Source Verification A thorough screening followed by continuous monitoring is es ..read more

How to Better Protect your Organization Through Medical Credentialing   Medical credentialing – the tedious but necessary process of verifying a provider’s credentials, including license(s) and exclusion status, education, and training. This process ensures that providers in your organization have the qualifications to deliver quality care to your patients. Medical credentialing, unfortunately, isn’t one-and-done at the time of hire. Healthcare organizations must regularly check practitioners’ qualifications and license status to comply with regulations and to ensure payment from pri ..read more

March Regulatory Update  – The best resource for monthly updates.   Here is our monthly regulatory update. See below for changes from several states introducing legislation. A big thanks to our compliance team, who monitors state, federal, and international updates.    Licensure Compacts:  Several states have introduced legislation to join the Nurse Licensure Compact, Advanced Practice Registered Nurse Licensure Compact and Interstate Medical Licensure Compact.  Nurse Licensure Compact (NLC)  Interstate Medical Licensure Compact Commission   Nurs ..read more

A Story About Provider Data, And Why It Has Become So Complex    While leaving her house to visit her grandson, Sue falls and twists her knee. At the emergency room, the doctors begin a series of tests to discover what’s wrong with her knee. Unfortunately, Sue’s knee injury is complex. It will take months for her to recover, and as she does, Sue will visit multiple clinics and doctors. Not only does Sue suffer the stress of pain and incapacity, but she also begins to feel like she needs a secretary to manage all of her appointments and bills. From the emergency room physician to ..read more