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.
CAQH, CMS, NPI … the world of medical credentialing and provider enrollment is full of acronyms. These can be difficult to keep straight, especially if you don’t deal with them every day.
To help you navigate this acronym-crowded world, we’ve created a list of common acronyms and their meanings. Let us know if we have omitted your favorite – or the one that you can never remember – by replying to this blog!
MFA – Multi Factor Authentication; used for security purposes when logging into a portal.
TIN – Tax Identification Number. This is issued by the Federal Government when you set up your business.
LOI – Letter Of Interest/ Letter Of Intent. This is sent to the commercial insurances when you initially apply for in-network status.
Medicare Acronyms:
CMS – Centers for Medicare & Medicaid Services.
NPPES – Organization that creates NPI numbers for individuals and businesses to streamline electronic submissions.
I&A – Identity and Access Management; the administrative access management site for Medicare to include the PECOS & NPPES systems.
PECOS – Provider Enrollment and Chain/Ownership System; an electronic Medicare portal where healthcare providers enroll and update their information.
NPI – National Provider Identifier; a unique 10-digit number assigned to healthcare professionals:
NPI Type I – This is for individuals who qualify for credentialing.
NPI Type II – This for a medical organization or business.
MAC – Medicare Administrative Contractor.
PTAN – Provider Transaction Access Number.
DMEPOS – Durable Medical Equipment, Prosthetics, Orthotics, and Supplies.
NSC – National Supplier Clearinghouse.
CP575 – Letter issued by the IRS which provides you with your tax ID number and the verification of the legal business name.
EFT – Electric Funds Transfer; set up through your clearinghouse to receive payments from insurances.
Top 10 Credentialing Vocabulary Words
Primary Source Verification – Direct confirmation of provider credentials from the issuing body. Used by hospitals, insurance companies and other regulatory bodies.
Payor Enrollment – Process to be approved with insurance plans to provide in-network services to patients.
Re-Credentialing – Regular process to re-verify a provider’s qualifications, usually every 3- 5 year.
Delegated Credentialing – When a payor allows a group to credential their own providers on behalf of the payors.
Attestation – A provider’s confirmation that submitted information is accurate.
Exclusions Check – Screening providers against OIG and other sanction lists.
Provider Roster – A list of all providers affiliated with a group practice.
Network Participation – Being contracted and active with insurance networks.
Application Lifecycle – The stages of submitting and completing a credentialing file.
Turnaround Time (TAT) – The time it takes to complete credentialing or enrollment.
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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!
