At 1ˢᵗ Credentialing we know that when our clients place their trust in us, we take that responsibility seriously by communicating with our clients to create a transparent and collaborative partnership.
Healthcare organizations of every size realize that hiring 1ˢᵗ Credentialing is the most economical and efficient way to solve their credentialing needs. We have the training, expertise and commitment it takes to keep a complex process moving forward at all times.
1ˢᵗ Credentialing supports healthcare practices of all sizes - from health systems, to community hospitals, to large group practices, to smaller organizations. We help get your providers up and practicing as fast as possible.
Learning more about the credentialing process benefits us and our clients. 1ˢᵗ Credentialing offers regular videos and newsletter updates to bring our clients and those interested in innovations in credentialing up to speed.
Would you be prepared if this audit were to happen next week?
The goal of CMS onsite audits is to find any fraud or abuse in the healthcare payment system. Some insurance payers are now joining in on-site audit visits. During the visit, CMS will make sure that your physical address matches the address on your electronic records and that your business is clearly labeled with street and number signs. They will also check that the proper licensed staff is providing professional services and that medical records are unaltered.
Checklist To Prepare for CMS Onsite Visit
You will receive a warning letter from CMS or from an insurance payer announcing your site visit. An unannounced visit may occur as well. Take action right away:
Check the credentials and photo ID of the auditors.
Let your attorney know about the audit and ask if they have any preparation advice or if they want to be present.
You may request that the appointment be rescheduled to a less busy time for your office.
Determine the exact purpose of the office visit and what issues they have observed in other providers.
Ask in advance whether any of your staff will be interviewed. If yes, brief them on how to answer questions accurately – but don’t volunteer any additional information.
Prepare a secure room in which the auditors can work.
If the audit is for only for medical records, ask for a patient list in advance.
Keep copies of all material that you supply to the auditors.
As a good practice drill for your staff, do a self-audit. Make sure that HIPAA standards are being met and that certificates are properly displayed. While you are at it, include safety standards in your audit for both OSHA and health department standards.
The auditors are only doing their jobs! Healthcare providers and suppliers must have policies and procedures in place for full compliance. When you are prepared for an audit at any time, you and your staff are confident that all proper HIPAA and other mandates are in place.
Let Us Manage All Your Payer Enrollment and Credentialing Services
If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, Vice President of Credentialing, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.
Our credentialing experts are here to help you assess exactly which solutions you need and let you know how inexpensively we could put you on the right track. 1ˢᵗ Credentialing includes primary source verification and payor enrollment for all insurance networks including Medicare, Medicaid, Medi-Cal and insurance networks. Don’t wait another minute, contact our terrific team today!