Credentialing Resources

Take deep dives into credentialing news, best practices, and technology with the andros team.

Case Studies

Humana Chooses andros as CVO Partner

When Humana began searching for a new CVO partner, they had clear criteria – their next vendor had to be a long-term solution to their problems. Our unique approach enabled Humana to proactively identify potential compliance issues and mitigate them before consequences arose.

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Delegated Credentialing: Easing the pain of credentialing your providers

Delegated Credentialing: Easing the pain of credentialing your providers Credentialing in house can be painful for health plans and other types of payors, adding the time and administrative stress of continually tracking and updating new providers, locations, and information. It can be burdensome for provider organizations too, submitting new documents with each provider, location and information changes, not to mention

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White Paper

Top 4 Challenges Facing Health Plans in 2022 and How to Overcome Them

From network development and staffing shortages to managing relationships in an increasingly digital world, health plans have a lot on their plates in 2022. How can leaders effectively navigate this difficult environment while continuing to provide exceptional services to members?   Introduction   Since the beginning of this tumultuous decade, health plans have been confronted with an unprecedented array of

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The lesser-known process affecting healthcare quality: Credentialing

Board of Directors Investor Portal The lesser-known process affecting healthcare quality: Credentialing By Mark Hirschhorn Over the last two years, we’ve gained more insight into the inner workings—and over-burdening—of the healthcare system than ever before. However, most people are still unaware of how much time-intensive administrative work is involved in the healthcare they receive. This work which takes countless hours

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White Paper

Roadmap to Innovation: What Payers Need to Compete in the Digital-First Healthcare Environment

Innovation is no longer optional for established health payers and digital native startups. Without revamping inefficient processes, payers risk falling behind in the race for provider participating providers and market share.Here are the first steps payers can take on the path toward sustainable, successful innovation.   Introduction   The health plan marketplace is evolving quickly as changing demographics, new regulations,

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White Paper

Top 4 Steps for Getting Started with Delegated Credentialing

FREE EBOOK Delegated credentialing can save time, money, and effort for health plans and provider groups. But it’s not for everyone.  Providers need to fully understand what’s involved and assess their readiness to take on enhanced credentialing responsibilities.  Here’s how.     Introduction   Credentialing is a key part of the provider enrollment process with significant implications for patient safety, care

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Credentialing verification organizations like you’ve never seen

Credentialing healthcare organizations has traditionally been difficult to manage efficiently. The lack of an industry standard, like the one NCQA offers for provider credentialing, leaves organizations and state regulatory entities to develop their own processes or requirements. Naturally, the result is a hodge-podge of standards with little consistency across the healthcare industry. The lack of an industry standard, however, does

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Recredentialing
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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 begin the recredential process? A:

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yacht sailing in the sea at sunset
Blog

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 do I know that my

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credentialing committee meeting
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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 it comes to running committee

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