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| Credentialing its providers’ has become a necessity with all Health Maintenance Organizations…. |
By:
Manpreet Kaur |
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Credentialing its providers’ has become a necessity with all Health Maintenance Organizations, locally owned managed care organizations as well as Preferred Provider Organizations. The credentialing process is followed by all health and medical care organizations because for them meeting the quality standards established by NCQA (National Committee for Quality Assurance) as well as URAC (Utilization Review Accreditation Commission) is a binding condition that they have to necessarily fulfill.
The medical credential verification procedure primarily involve verifications of licenses, verification of malpractice insurance, verification of college degrees and background checks to unfold any violations or criminal activity. The credential verification process is undertaken to facilitate timely collection of copies of college degrees, copies of professional certificates, relevant training records, licensor documents, certifications, and copies of registration to practice in a health care field. After obtaining the necessary copies and documents they are put to stringent investigations for ascertaining its authenticity and for determining the truthfulness of providers’ data. Assessment is also made with regards to whether the practitioner complies with every established criteria pertaining to professional competence as well as moral conduct.
In order to be considered eligible for participating in health insurance plans of insurance carriers all providers’ have to satisfy the credential verification conditions as set by NCQA (National Committee for Quality Assurance) as well as URAC (Utilization Review Accreditation Commission). The review and verification process mainly involves verification of current professional licenses, current drug enforcement administration and controlled drug substance certificates, verification of education, post graduate training, hospital staff privileges and levels of liability insurance.
Med Advantage is one of those reputed organizations based in Orlando, Florida that has been catering to the needs of Health Management Organizations (HMOs) and Preferred Provider Organizations (PPOs). The company is known nation wide as the provider of quality, efficient, and reliable credential verification services to its clients that also include several Fortune 500 companies. The plethora of services offered by Med Advantage consists of verifying credentials such as Board Certifications, Criminal Background Checks, Verifications of state licenses, Checks regarding work history, and verification of professional references.
Credential verification |
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