Medical credentialing is an essential process for evaluatinga healthcare professional's qualifications, competency, and practice history. By verifying a practitioner's education, training, licensure, and board-issued certifications, you are not only confirming his or her qualifications, you are offering assurance to your payers that the individual meets requirements for practice and reimbursement. In fact, you are endorsing them as the qualified individuals who will be representing your healthcare facility or organization.
Protecting against hiring or doing business with excluded or debarred individuals or entities is a must for any healthcare organization. Failing to determine exclusion status can result in hefty civil monetary penalties for your organization. Exclusion screening offers this protection, enabling screening that establishes a provider’s eligibility to treat patients and receive payments from federal and state health plans. Here we will discuss what’s behind exclusion screening and why healthcare organizations need to screen.
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