General Credentialing

Recredentialing

Recredentialing Q&A – What You Need to Know

Q: How often are practitioners recredentialed? A: Practitioners and facilities are typically recredentialed every three years unless a state or health plan has different requirements. It is important to recredential practitioners and facilities in order to verify their ability to continue providing the services for which they are contracted. Q: What preparation is needed to …

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The Journey to Achieving Delegated Credentialing

Have you been thinking about applying for delegated credentialing? Not sure where to start? Going through the process of achieving delegated credentialing might seem like a huge undertaking, but with the right preparation and partner, it can be a straightforward process. We’ve created a guide for you, outlining the basics of achieving delegated status. When …

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credentialing committee meeting

Best Practices for Credentialing Committee Meeting Management

As you probably already know, NCQA requires health plans to meet periodically to make credentialing decisions about network practitioners. During this process, known as a committee meeting, outside experts will determine whether providers should continue to be credentialed for the network. These regular meetings are critical for health plans’ compliance, but many plans struggle when …

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Mike Simmons

Mike leads a team dedicated to each other, our clients, and our mission to make healthcare administration work better. His vision is to provide an end-to-end solution designed for 21st century healthcare organizations. Mike is a student of Brazilian jujitsu, enjoys road cycling, paddling, and surfing, and aspires to be a true ally to people across the entire spectrum of diversity.