Are you frustrated yet? That big box health plan has been credentialing your provider for almost a year, and you just keep giving away free healthcare services waiting for that retro to take effect. Yes, you are. So are they. They, the health plans, are overwhelmed with volumes. And, also overwhelmed with trying to perform delegation audits in a timely fashion. Let’s face it. Most of us credentialing professionals love our jobs and would hate for them to disappear due to the

The side of credentialing that doesn’t get any attention is organizational credentialing. At first sight, it looks a lot less complicated than practitioner credentialing. But, is it? There are the basic requirements – licenses in good standing, certification or accreditation, and quality assessments – required by NCQA and CMS. So, what else would you have to do? The answer to that may vary by state, as well as organizational type. What is clear is that every managed care org