In our last post, We had a close look at Credentialing and what it entails. We also gained insight into how healthcare companies and providers manage this very important function in healthcare recruitment. Having understood why healthcare credential management is so crucial not only from a business perspective but also ensures there are no legal implications, the stage is just right to introduce another factor closely related to Credentialing, namely Compliance.
Join me in exploring why Compliance in Credentialing is so important and how this need not be such an onerous task with specialized apps, customized specifically for online healthcare recruitments. Credential compliance is achievable with minimal stress. Let us understand how, but first-a brief background.
What is Compliance in Credentialing, and Why does it matter?
I am using the the term ‘Compliance’ to mean meeting the requirements for Credentialing and participating in effective Compliance programs as set forth by the Office of Inspector General (OIG) and the National Committee for Quality Assurance(NCQA). This includes internal auditing, monitoring, credentialing education and training, developing plans of corrective action in responding to related problems as well as enforcing credentialing standards. Most Compliance programs, while generally operating as independent entities, report to their respective boards of directors or other committees providing assistance and oversight to the process.
So, what happens if a healthcare fails to verify accurately? Without careful oversight and auditing, it is all too possible for omissions or errors to occur before, during, or immediately following the process, which could lead to enrollment issues as well as open a pandora’s box to legal problems if the process is incomplete or the provider’s privacy is compromised. Furthermore, the 1960s case of Darling vs. Charleston Hospital established the responsibility of hospitals and other healthcare facilities in verifying the professional credentials of the physicians and other providers practicing under their roof.
REF : links :https://targetrecruit.com/the-importance-of-compliance-in-credentialing/
YouTube: https://youtu.be/C6YrPt1ygX8
