CT Medicaid Enhanced Provider Enrollment Screening
Fingerprint Based Criminal Background Checks Effective October 13, 2016 the Connecticut Medicaid program will begin requiring fingerprint based criminal background checks (FCBC) for all providers designated as a "high" categorical risk. The new screening measures...
MassHealth (MA Medicaid) Plan Changes
MassHealth Ordering, Referring, and Prescribing Policy There are some significant changes taking effective September 1, 2016 with the Massachusetts Medicaid program (MassHealth). Every provider licensed in the state must now have an active enrollment record with...
Credentialing After Relocation – What Is Needed?
Insurance Credentialing After You Relocate We routinely hear from healthcare providers who have relocated to another state or are planning a relocation, and need assistance with getting in-network with insurance panels in their new practice state. Many are frustrated...
Medi-Cal provider enrollment going electronic
Medi-Cal’s Doctor Sign-Up System Finally Going Online Medi-Cal’s enrollment system for doctors and other health care providers, long criticized in the medical community for being complicated and slow, is getting an overdue transformation. Paper is out, computers are...
New Physician Credentialing – Timing is Everything
It is always a good sign when your practice recruits a new physician fresh from medical school. It brings attention to your practice, and can help you build a reputation of being a forward-thinking practice that offers the newest and best patient care practices. ...
Provider Enrollment Requirements for Medicare Part D
Deadline for enforcement of provider enrollment requirements for prescribing Medicare Part D drugs has changed In 2014 CMS announced that all provider's who write prescriptions for Part D drugs must have an approved Medicare enrollment record or a valid Opt-Out...
Common Payor Enrollment Mistakes
Whether you are starting a new solo practice or adding a new physician to an existing large medical group, an efficient process for credentialing and contracting with insurance networks is key to minimizing financial loss when you begin seeing patients. The process...
CMS Proposed Required Disclosures During Provider Enrollment
CMS Announces Program Integrity Enhancements to the Provider Enrollment Process CMS announced a proposed rule for implementing additional provider enrollment provisions of the Affordable Care Act to help identify entities and individuals who pose risks to the Medicare...
CMS Revalidation – Cycle 2
The CMS Revalidation Project The Affordable Care Act established a requirement for all enrolled providers/suppliers to revalidate their Medicare enrollment information under new enrollment screening criteria. The Centers for Medicare & Medicaid Services (CMS) has...
CMS updates provider enrollment screening
Strengthening Medicare Provider Enrollment Screening Medicare has long had screenings for address verification and site visits, however, an update in their screening processes will put more emphasis on these screening methods. CMS will also implement a policy to...
CFHC Selects nCred for Credentialing Needs
Press Release: Chattanooga, TN -- Carolina Family Health Centers has contracted with National Credentialing Solutions (nCred) to provide the practice with credentialing services. Carolina Family Health Centers is located in Wilson, North Carolina and services...
What telemedicine parity laws mean for physicians
Telemedicine parity laws If you’re a physician looking into telehealth, you’ve probably had to learn a new vocabulary --- from originating patient site to telepresenter. At the top of these must-know telemedicine-related terms is the telehealth parity law. Knowing a...
