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.
New legislation has placed a greater emphasis on provider directory accuracy. Please make sure the practice location information in the CAQH ProView profiles referenced below is up to date. Health plans are using CAQH ProView to collect provider directory information.
If the provider is now practicing at a new location, has a change to an existing location or is no longer practicing at a location, please have the provider log in to the ProView account and make those changes.
If details about the practice have not changed since the provider’s last attestation or confirmation, a ‘No Change’ indication must be made for each active practice location for the provider.
A full provider attestation is not needed for these types of updates. Confirmed practice location data (updates or a confirmation of “No Changes”) will be sent to health plans upon clicking the save button.
While CMS has previously focused on Medicare and Medicaid directories, the No Surprises Act is a federal law that extends directory accuracy requirements to commercial plans. The Act also recognizes that ensuring directories are accurate is a shared responsibility of both plans and providers. These regulations:
Require providers to
Maintain a database of provider directory information.
Launch a verification process to update provider directory information quarterly.
Require plans to
Implement a process to remove unverified providers quarterly.
Execute a process for updating provider directory information within two-days of receipt from the provider.
Implement a response protocol that ensures a provider’s network status request is responded to within one business day and communication is maintained for two-years.
To learn more about 1st Credentialing and the services we provide, please visit us at 1stCredentialing.com
At 1st Credentialing, we strive to make the Payor Enrollment process as simple and easy as possible for our clients. To learn more about 1st Credentialing, please visit our website or join our Facebook group, Credentialing Talk, where we discuss all the latest credentialing trends and news.
Our credentialing experts are here to help you assess exactly which solutions you need to put you on the right track. 1ˢᵗ Credentialing includes payor enrollment for all insurance networks. Don’t wait another minute, contact our team today!