healthcare compliance and credentialing

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Articles to make governance, risk, & compliance the simplest part of your day.

Kathy Matzka

Kathy Matzka is a speaker, consultant, and writer with 30 years of experience in credentialing, privileging, and medical staff services. Her clients represent a variety of healthcare organizations, including hospitals, long-term care facilities, managed care organizations and physician practices. She has also worked extensively with the National Association Medical Staff Services’ (NAMSS) Library Team, developing and editing educational materials to help organizations meet the rigorous standards and expectations of today's healthcare industry. She is one of the first recipients of the NAMSS Fellow Designation. The Fellow Designation is the pinnacle of achievement and acknowledgment for the Medical Services Professional (MSP), recognizing a career MSP who has made outstanding contributions to the profession through service as a leader, mentor, and educator. Kathy’s experience as an expert witness for almost 50 negligent credentialing claims offers unique insightinsights into steps healthcare professionals can take to mitigate the risk of negligence in credentialing.

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Payor Enrollment

Five Steps to Expedite the Payor Enrollment Process

By: Kathy Matzka
September 28th, 2016

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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Payor Enrollment

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

By: Kathy Matzka
September 15th, 2016

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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symplyr top blog posts of 2017

Top 10 Posts of 2017

It's packed with valuable insights to make governance, risk, and compliance the simplest part of your day.

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Provider Credentialing | Healthcare Provider Credentialing | Provider Privileging

Negligent Credentialing Lawsuits: Case Law Examples

By: Kathy Matzka
July 19th, 2016

Valuable Insights for Provider Credentialing and Privileging Team When it comes to ensuring the physicians at your medical hospital or healthcare organization provide high quality care, your first line of defense is a thorough provider credentialing and privileging process. Making sure your medical services professionals (MSPs) have access to up-to-date provider information is just one of several important steps to mitigating the risk of negligence in credentialing and privileging.

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Provider Credentialing | Healthcare Provider Credentialing | Provider Privileging

Five Tips for Mitigating the Risk of Negligence in Provider Credentialing and Privileging

By: Kathy Matzka
July 14th, 2016

As you know, provider credentialing and privileging is crucial to your compliance program – and to protecting the safety and welfare of your patients. To ensure quality patient care and help shield your organization from negligent credentialing lawsuits, start by making sure your teams have access to a reliable, up-to-date provider privileging database. Then, follow these steps to further reduce your healthcare organization’s risk of negligence in credentialing and privileging:

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