Showing Posts In "Healthcare Screening, Credentialing & Exclusion Screening" Category

Understanding Credentialing in Healthcare Staffing: Using Automation to Streamline Processes and Placements

The credentialing process in the healthcare setting can be complex and time-consuming. The five key components of the process include verification of education and training, licensure and certification validation, professional experience assessment, background checks and screening, and ongoing monitoring and compliance, Automating the process can help ensure efficiency and time savings, enhanced accuracy and compliance, […]

OIG Exclusion List: How to Avoid Penalties

It is critical for organizations to understand the OIG exclusion list, or they could face hefty fines or be restricted from filing claims with Medicare and Medicaid. The list includes all individuals and entities that are excluded from working or providing goods or services to any organization in the healthcare industry. A person or entity […]

Best Practices for Monitoring

Out of 1,000 licensed healthcare practitioners, 20 of them will be practicing with an inactive license, 10 with a suspended license, and six with either restricted or revoked licenses or probation. There are several best practices when it comes to credentialing policies and procedures. These include identifying the licensed independent practices whose credentials must be […]

How Primary Source Verification and Monitoring Keep Your Patients Safe

The Office of Inspector General’s List of Excluded Individuals and Entities (OIG-LEIE) is a great source for hospitals, but making this the only source could lead to missing current and previous sanctions. Ongoing monitoring can allow hospitals to obtain real-time sanction and exclusion updates, as well as provide a glimpse into the history of those […]

The OIG White Paper

This white paper is designed to provide the latest information to medical HR and compliance professionals; either as a “refresher” for what’s already known, or a source for updated rules, regulations, and processes.

– The OIG itself
– Penalties for Violation(s)
– The Permanence of Exclusions
– Types of Fraud & Abuse
– Plus a lot […]

Where to Implement Exclusion Monitoring

The end of the year is the perfect time to evaluate current compliance programs that use effective processes and procedures to define, detect and prevent state and federal violations in healthcare, including patient care, physician license verification, billing, reimbursement, HIPAA privacy, and security. Allowing an excluded provider to practice can lead to severe consequences for […]

OIG Exclusions Screening: Best Practices for Healthcare

Individuals and entities can be excluded from receiving funding from federal healthcare programs and the Office of Inspector General (OIG) maintains a list in an online searchable database. Those who hire someone who is on the list can be subject to civil monetary penalties (CMP). Organizations are still on the hook if an individual is […]

5 Common Myths About Healthcare Background Screening

Background screening is a necessary part of the hiring process, but it can be complicated and confusing in the healthcare industry. There are several myths surrounding this important process, including that conducting an OIG/GSA check meets CMS Requirements for sanctions and exclusions screening. Many also believe that doing an enhanced nationwide search, or searching the […]

Understanding Healthcare Screening

Sanction and exclusion monitoring are part of a vital areas of compliance in the healthcare hiring space. A healthcare sanction, or an administrative action taken against an individual, an individual’s professional license, or an entity, involves serious consequences, such as exclusion that prohibits the sanctioned individual or entity from providing federally funded healthcare services or […]

How a Higher Standard of Screening Can Keep Your Healthcare Business in Compliance

As the COVID-19 pandemic has demonstrated, the service that healthcare professionals offer to United States citizens is crucial to a thriving American society. Organizations that employ workers in this sector should perform their due diligence to ensure that each of their providers/practitioners is properly licensed, have a clean history with their licensing board, and are […]