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The CMS Preclusion Blind Spot: How One Bad Provider Can Hide Behind a Dozen Good Numbers

Medicare has a list of providers who should never get paid again. An OIG audit found the government’s own system keeps losing track of who […]
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When “Excluded” Doesn’t Mean Gone: Exclusion Evasion in a $4.75M Medicare Case

Exclusion from Medicare and Medicaid is meant to be a hard stop — no billing federal programs, no working in a billing-connected role, and no […]
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Graphic featuring the NCQA Certified Credential Verification Organization seal Blog

ProviderTrust Earns 3-Year NCQA Credentialing Certification

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The Industry Keeps Announcing “The First” Shared Credentialing Program

By Christopher Redhage, Co-Founder and Managing Partner, ProviderTrust The industry loves throwing this launch party. This is the second one in about thirteen months with […]
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Highlights from the OIG Spring 2026 Semiannual Report to Congress

The U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) has released its Spring 2026 Semiannual Report to Congress, summarizing its oversight […]
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What 150 Healthcare Executives Really Think About Provider Eligibility Data Featured Image Blog

What 150 Healthcare Executives Really Think About Provider Eligibility Data

Provider eligibility data touches nearly every corner of a healthcare organization. It underpins some of the most consequential decisions an organization makes — from hiring […]
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Can Excluded Physicians Refer, Order or Prescribe? Featured Image Blog

A Race Against Time: Why Timely MFCU Reporting Is Vital to Medicaid Program Integrity

Do you have the resources; time and or people? Do you have the expertise? Do you have an internal audit team or are you using contract auditors?

How often should you audit? What do you do with the audit findings? I am tired already, and we haven’t even gotten started.

*Updated from original post on 11/15/2016

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SFTP vs API : Which Integration Method Is Best? Featured Image Blog

The Credentialing Data Gap: Why Payer Teams Are Still Chasing Data Manually

Do you have the resources; time and or people? Do you have the expertise? Do you have an internal audit team or are you using contract auditors?

How often should you audit? What do you do with the audit findings? I am tired already, and we haven’t even gotten started.

*Updated from original post on 11/15/2016

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How to Conduct an Effective Healthcare Compliance Audit

Do you have the resources; time and or people? Do you have the expertise? Do you have an internal audit team or are you using contract auditors?

How often should you audit? What do you do with the audit findings? I am tired already, and we haven’t even gotten started.

*Updated from original post on 11/15/2016

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