Credentialing and Payer Enrollment: What’s the Diff?

Medical credentialing means doing a kind of background check on doctors and other healthcare providers. So credentialing is required for individuals who provide health care.

Are You Ready for a CMS Site Visit?

Whether you are a new provider or you have been in practice for some time, the Centers for Medicare & Medicaid Services (CMS) may pay enrolled providers a visit for a medical record review and audit.

Has Your Practice Experienced Changes that Must Be Reported to CMS? 3 Critical Mistakes To Avoid

Once your practice is enrolled in Medicare, don’t just sit back and relax! There are certain business changes that must be reported to the Centers for Medicare & Medicaid Services (CMS) on a timely basis, or your practice risks suspension or losing eligibility for Medicare reimbursements.

Texas HHS Consolidating Provider and Enrollment Processes Into New System by 2020

The Texas Health and Human Services Commission (HHSC) is getting ready to roll out its new provider and enrollment system. By consolidating and replacing some processes and systems, the new Provider Management and Enrollment System (PMES) will reduce administrative burden for providers.

Why Insist on Primary Source Verification?

In the world of medical credentialing, it’s essential to ensure that information and documentation are accurate. The best way to accomplish this is by using a primary source to verify provider credentials.

Introducing New 1st Cred Software

1st Assistant is excited to announce our new proprietary software product 1st Cred!

This sophisticated, comprehensive credentialing software has been developed BY credentialing professionals FOR credentialing professionals. 1st Cred contains complete processes for payer enrollment and primary source verification services.

CMS Issues Revised Medicare Beneficiary Identifier Notice for Medicare Advantage Plans

The Centers for Medicare & Medicaid Services (CMS) recently issued a revised MLN Notice concerning the new Medicare Beneficiary Identifier (MBI).

CMS Extends Implementation of New ACA-Required Provider Enrollment Changes

March 1, 2016 seems like a long time ago. That is the date that the Federal Register published a proposed rule titled “Medicare, Medicaid and Children’s Health Insurance programs; Program Integrity Enhancements to the Provider Enrollment Process.”

Lofty Goal Set To Provide Individual Digital Health Records

The Health and Human Services Department (HHS) is working to make digital health data accessible to individuals on smartphones or other devices.

Are You in Line for a Medicare Targeted Probe and Education Audit?

It’s known as a TPE review. Have you heard of it? A Centers for Medicare & Medicaid Services (CMS) Targeted Probe and Education audit is a periodic review with the goal of reducing claim denials and appeals by providing claim review along with one-on-one provider education.

CMS Lifts Home Health Agency Moratorium On Medicare and Medicaid Enrollment

The Centers for Medicare & Medicaid Services (CMS) has lifted its temporary home health agencies (HHA) moratorium for Medicare and Medicaid provider enrollment in certain states.

Medicare and MedicaidHeidi HendersonFebruary 22, 2019HHA Enrollments, CHIP, medical credentialing, Medicare, Medicaid, CMS

CMS Announces New Medicare Enrollment Form for Physician and Non-Physician Practitioners

The Centers for Medicare & Medicaid Services (CMS) has developed and received approval for a new Medicare Enrollment Application.

The new form applies to both physicians and non-physician practitioners who use paper applications to Medicare.

Medicaid 2019: What To Watch For

Medicaid is a huge provider of health insurance coverage. This program covers about one in 5 Americans and is the largest payer for long-term care services.

Medicare and Medicaid1ST ASSISTANT CREDENTIALING SERVICESFebruary 4, 2019medicaid, medicaid 2019

CAQH 2018 Index Report Shows Welcome Increase in Automated Transactions

The healthcare industry is making progress in automating business processes. That is the conclusion of the recently released Council for Affordable Quality Healthcare (CAQH) 2018 Index Report.

CAQH1ST ASSISTANT CREDENTIALING SERVICESFebruary 1, 2019medical credentialing

Save Time, Money and Worries by Outsourcing Payer Enrollment

Do you have idle staff members looking for more work to do? Do you and your team have so much extra time that you are constantly creating busywork for them? In short, are you fulfilling all your payer enrollments, reenrollments and medical credentialing tasks perfectly, accurately and with plenty of time to spare?

Medicaid 2019: What To Watch For

A recent online article from the Kaiser Family Foundation covered important Medicaid issues to watch in 2019.

Medicare and Medicaid1ST ASSISTANT CREDENTIALING SERVICESJanuary 18, 2019medicaid, Medicare

CMS Audit Finds Medicare Advantage Provider Directories Woefully Deficient

Knowledge Center, Credentialing Requirement, State Specific Info1ST ASSISTANT CREDENTIALING SERVICESJanuary 10, 2019medicare

CAQH Announces Important Changes to VeriFide Credentialing System

The Council for Affordable Quality Healthcare (CAQH) recently announced changes to its VeriFide™ system.

Credentialing Requirement, CAQH1ST ASSISTANT CREDENTIALING SERVICESDecember 27, 2018payroll, healthcare

CMS Issues Blanket Waivers for Those Impacted by Alaska Earthquake

The Centers for Medicare & Medicaid Services (CMS) has once again issued emergency instructions for providers and suppliers who submit claims to Medicare Administrative Contractors. The interim processes are applicable to beneficiaries who were affected by the November 30th Alaska earthquake.