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symplr vendor credentialing blog

Five Steps to Expedite the Payor Enrollment Process

Payor enrollment is a diverse and ever-changing process. With so many rules and regulations in place, it can take several weeks - and even months - to get applications approved. By developing an efficient payor enrollment process, you can ensure your provider’s applications for medical staff appointment and privileges and enrollment in health plans are processed as quickly as possible.

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Topics: Payor Enrollment

Seven Tips to Help Advance Your Credentialing Career

It’s no secret that healthcare is changing rapidly, and you’ve likely seen the drastic transformation firsthand. The world of healthcare provider credentialing is no exception—from new government regulations to the specialization of professional titles and the introduction of new technologies that automate the repetitive tasks of your daily work.

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Topics: Payor Enrollment

Payor Enrollment: Understanding the CMS Guidelines for Hospitals and Health Plans

When it comes to processing enrollment applications, there are many requirements for hospitals and health plans, including Centers for Medicare and Medicaid (CMS) and state regulations, as well as requirements established by various healthcare accreditors. With so many rules and regulations in place, it can be difficult to navigate the payor enrollment process—let alone get applications approved in a rapid manner.

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Topics: Payor Enrollment

What’s in a Title? How the Role of Credentialing Professional is Changing

In your role as a credentialing professional, you likely tackle many tasks and projects at work each day. Some tasks, like sending and receiving verifications, could certainly benefit from new automated technologies to make you more efficient. Others, such as investigating red flags on new applications, take more time—and a human touch. But no matter what your work day includes, you need to understand how the credentialing role is evolving and how your career might benefit from these changes.

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Topics: Payor Enrollment

Four Major Challenges of the Peer Review Process

Did you know that an effective peer review process at your healthcare facility can have a major impact on quality of care? In its broadest sense, peer review has a direct affect over a health organization’s quality assurance and performance improvement activities. Having a failing peer review process can lead to both major financial and legal problems. That’s why it’s important to understand the inherent challenges of peer review to avoid having a weak review system. 

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Topics: Peer Review Software

Visitor Management Improves Hospital Safety & Security

It goes without saying that medical hospitals are busy places. Patients, physicians, employees, volunteers, and vendors alone translate to thousands of people every day – add visitors to the mix, and the total number rises by thousands or even tens of thousands every month.

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Topics: Visitor Management, Hospital Safety

Change Management: Understanding the Emotional Impact of New Technology in the Workplace

payor enrollmentStress, frustration, and anxiety – these are all typical responses when someone tries to change our usual way of doing things. Of course, this includes technology (especially technology!). Why is change so hard? Probably because we take comfort in our familiar routine and daily workflow.

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Topics: Payor Enrollment

Immunity and Confidentiality: The Legal Significance of Peer Review

For most healthcare organizations, conducting medical staff peer reviews is a central component of quality management. The majority of insurance companies, accreditors, and regulatory bodies require consistent peer review as part of the credentialing process. Although peer review is widely practiced as an industry standard, its implications are often misunderstood. 

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Topics: Peer Review Software

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