What is Provider Enrollment
Provider Enrollment (or Payor Enrollment) refers to the process of applying to health insurance networks for inclusion in their provider panels. For Commercial Insurance networks, this process involves two steps, 1) Credentialing and 2) Contracting. The first step...
CMS Improves Functionality With NPPES Updates
Updates to NPPES CMS has launched an updated version of the National Plan and Provider Enumeration System (NPPES). The new unified login for NPPES makes it easier for users to manage type 1 and type 2 NPI records, increases security, provides new surrogacy...
New Practice Credentialing
Insurance Credentialing For New Health Care Practices Opening a new health care practice takes time, patience, money, and perseverance. Like starting any new business there are hundreds of tasks that need completing to get ready to open your doors. Healthcare...
Mass Health Changes in Mid-Level Provider Enrollment
Changes to Mass Health Enrollment for Mid-Level Practitioners; Physical & Occupational Therapists; Independent Nurses. MassHealth, the state Medicaid program for Massachusetts, is moving forward with Mid-Level Practitioner amendments proposed in April of this...
Medicare Removes Social Security Numbers from Cards
New Medicare cards offer greater protection to more than 57.7 million Americans New cards will no longer contain Social Security numbers, to combat fraud and illegal use The Centers for Medicare & Medicaid Services (CMS) is readying a fraud prevention initiative...
CMS Renames Locum Tenens Arrangements
Changes to the Payment Policies for Reciprocal Billing Arrangements and Fee-For-Time Compensation Arrangements (formerly referred to as Locum Tenens Arrangements) The Centers for Medicare & Medicaid Services (CMS) is amending the terminology it uses to describe...
CMS Updated Manual Guidelines for Change of Ownership
Updated Manual Guidelines for Electronic Funds Transfer (EFT) Payments and Change of Ownership (CHOW) The Centers for Medicare & Medicaid Services (CMS) issued Change Request (CR) 9953 (effective May 15, 2017), for the purpose of making revisions to Chapter 15,...
Tricare Merges Regions for 2017
Tricare Provider Enrollment There are some changes to the Tricare program for 2017. The new "East Region" merges the current north and south regions to make a new singular region. The U.S. Department of Defense announced that the East region will be managed by...
The Payer Provider Enrollment Process
What is Provider Enrollment? Provider Enrollment (or Payor Enrollment) refers to the process of applying to health insurance networks for inclusion in their provider panels. For Commercial Insurance networks, this process involves two steps, 1) Credentialing and 2)...
Corporate Practice of Medicine in California
The state of California has specific guidelines for medical practice organizations forming business entities. Essentially the state requires medical corporations to be formed as a Professional Corporation (PC), the make-up of the corporation a must be at least 51%...
New CMS Specialty Code for Hospitalists
When they enroll in the Medicare program, physicians self-designate their Medicare physician specialty on the Medicare enrollment application (CMS-855I or CMS-855O), or in the Internet-based Provider Enrollment, Chain and Ownership System (PECOS). CMS uses these...
nCred Client Portal
Another nCred Advantage nCred is excited to launch a new client portal that will improve the ease of access to credentialing information for healthcare organizations to better oversee the credentialing process for its providers. The new nCred client portal is...
