Periodic appraisal of a provider’s current competence after they’ve been granted initial privileges and/or appointed to the medical or professional staff is the process you know as reappointment. Your organization may follow the accreditation or regulatory standards of CMS, Joint Commission, DNV, or NCQA. Regardless, they each provide a solid foundation for healthcare organizations to…
1. Proposed Changes to Medicare Billing Privileges CMS has introduced a proposal that should grab the attention of credentialing and enrollment professionals. If finalized, it would change select rules for Medicare billing privileges. The proposed rule, in CMS’ 2020 Medicare Physician Fee Schedule, recommends applying Medicare enrollment approval and revocation rules for opioid treatment programs…
To borrow from the driving drill, practicing “defensive verification” means verifying to save lives, time, and money, in spite of the conditions around you and the actions of others. Done well, it may take more time upfront but it saves lives and money in the long run. It also takes fortitude, when enrollment specialist are…
Are you a medical staff office whiz or are you working your way into the profession? Take our 10-question quiz and discover where you rank! (Answers and score key far below) 1. A credentials verification organization’s (CVO’s) primary function is to: A. monitor monthly sanction files for its clients B. primary source verify licenses…
It used to be only forward-thinking healthcare organizations that produced plans and policies reflecting their preparation for disasters or emergencies. It’s no longer just an interesting undertaking—to educate about and create a complete plan to avoid the unqualified provision of patient care, despite the swirling chaos of a situation. Today, it seems as if disasters…
Whether your organization’s Joint Commission accredited or follows standards and regulations of another body, your department or function likely will be included in a surveyor’s visit. This blog doesn’t tackle the type of sustained good policy, adherence to the standards, and prep the organization needs to remain in a constant state of readiness. Rather, it…
