Key Takeaways In FY2024, OIG excluded 3,234 individuals and entities from federal healthcare programs and reported over $7 billion in expected enforcement recoveries from that...
Key Takeaways Dental credentialing delays cost practices between $9,000 and $15,000 per provider per month per AAPC estimates — a 90-day delay across five to...
Key Takeaways Medicare credentialing verifies provider qualifications, while enrollment authorizes billing — both must be completed before submitting any claims to CMS for reimbursement. A...
Key Takeaways Every healthcare organization participating in Medicare or Medicaid must screen all providers, employees, contractors, and vendors against the OIG LEIE before hire and...
Key Takeaways NCQA is more widely recognized by commercial payers and health plans while URAC has stronger adoption among specialty payers, managed care organizations, and...
