Pennsylvania Targets Credentialing Problems With New Legislation
Pennsylvania lawmakers attempt to improve provider credentialing turnaround times with insurance networks.
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Medicare Provider Enrollment Program Integrity Enhancements
A new rule regarding Medicare provider enrollment allows CMS to revoke healthcare providers or suppliers' Medicare enrollment if they are affiliated with targeted "bad actors". As part of the CMS' "Program Integrity Enhancements to the Provider Enrollment Process"...
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Michigan Medicaid Requires Prescribing Providers To Enroll
Michigan health providers must enroll by Oct. 1 Beginning October 1, 2019, Medicaid beneficiaries with prescriptions written by healthcare providers who are not enrolled with the Medicaid program will not be able to have the prescription filled. Federal requirements...
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CMS Address Edits May Cause Claim Denials
The Centers for Medicare & Medicaid Services (CMS) recently announced implementation of validation edits in the Medicare enrollment system that may cause claim denials. These validation edits will apply to hospital outpatient prospective payment system (OPPS)...
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Welcome to nCred!
By now you should have received an email with login information to the nCred Portal located at https://portal.nationalcredentialing.com. If not, please email support@nationalcredentialing.com or call our office at 423.443.4525 to speak with our support staff. The...
read moreTexas Medicaid To Improve Provider Enrollment Process
Texas Health and Human Services Commission (HHSC) announced that it is undertaking an update to its provider enrollment system. HHSC has selected a vendor to design and implement a new provider management and enrollment system for the state's Medicaid program. The...
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FL Medicaid Moratorium on New BA providers
Florida Medicaid extends moratorium on new enrollment of BA providers in Miami-Dade and Broward counties.
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Medicare Application Fee for CY 2019
CMS announced the application fee for calendar year (CY) 2019 will be $586 for institutional providers that are initially enrolling in the Medicare or Medicaid program or the Children's Health Insurance Program (CHIP); revalidating their Medicare, Medicaid, or CHIP...
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Maryland Medicaid Provider Enrollment Portal
Providers who bill Maryland medicaid are now required to enroll with the electronic Provider Revalidation and Enrollment Portal (ePREP)
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Medicare Provider Enrollment – What is PECOS?
Medicare Provider Enrollment There are two ways to enroll with the Medicare program. First, complete the appropriate Medicare paper applications, or second, use the Medicare Provider Enrollment, Chain, and Ownership System (PECOS). This article focuses on provider...
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Payer Enrollment – The 1st Step In The Revenue Cycle
Payer enrollment services help healthcare organizations to unravel the complex process of credentialing providers and enrolling them in payer networks. Payer enrollment is the process of a provider joining a health insurance plan’s network. The process includes...
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Negative Impact of Medicare Administrative Contractor Changes in 2018
Medicare Administrative Contractor Changes in 2018 In 2018, the Medicare Administrative Contractors (MAC's) for TN, GA, And AL changed from CAHABA to Palmetto. The change has had a dramatic impact on the turnaround time of Medicare provider enrollment applications. ...
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