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Posts tagged "Risk Assessment"

What is Healthcare Provider Data Management?

July 1, 2025 / admin / Articles, Blockchain, Healthcare Data Management, Healthcare Provider Data Management, HIPAA, Provider Data, Provider Data Management, Regulatory Bodies, Regulatory Changes, Regulatory Compliance, Risk Management
Healthcare Provider Data Management

Data isn’t just information. It’s the lifeblood that powers every aspect of patient care, operational efficiency, and strategic decision-making. Healthcare Provider Data Management (HPDM) represents the systematic approach to collecting, storing, organizing, protecting, and utilizing the vast amounts of data that flow through healthcare organizations daily. From electronic health records to billing information, from clinical […]

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Blockchain, Healthcare Data Management, Healthcare Provider Data Management, HIPAA, Provider Data, Provider Data Management, Regulatory Bodies, Regulatory Changes, Regulatory Compliance, Risk Assessment, Risk Management

Managing Red Flags in Provider (Credentialing) Applications: A Risk-Based Framework

January 1, 2025 / admin / Articles, Credentialing, Credentialing Applications, Credentialing Challenges, Credentialing Criteria, Credentialing Problems, Credentialing Red Flags, Credentialing Risks, Provider Applications, Risk Assessment
Credentialing Application Red Flag Management

You’ve seen it before; you’re reviewing a provider application and something just doesn’t seem right. Maybe it’s an unexplained gap in work history, a malpractice case that wasn’t disclosed, or inconsistent information across different sections of the application. Your instincts are telling you to dig deeper, but how do you approach these red flags in […]

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Credentialing, Credentialing Applications, credentialing challenges, Credentialing Criteria, Credentialing Problems, Credentialing Red Flags, Credentialing Risks, Provider Applications, Risk Assessment

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Practices Served

  • Behavioral Health
  • Primary Care
  • DME
  • Home Health
  • Urgent Care
  • Radiology
  • Cardiology
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Speech Therapy
  • Orthopedic & Rheumatology
  • Genetic Testing
  • Geriatric Medicine
  • Pharmacogenetic (PGx)
  • Fertility Preservation
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • Biologics & Specialty Drugs
  • Telestroke & Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Practices Served

  • Behavioral Health
  • Primary Care
  • DME
  • Home Health
  • Urgent Care
  • Radiology
  • Cardiology
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Speech Therapy
  • Orthopedic & Rheumatology
  • Genetic Testing
  • Geriatric Medicine
  • Pharmacogenetic (PGx)
  • Fertility Preservation
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • Biologics & Specialty Drugs
  • Telestroke & Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Recent Posts

  • White Male Medical Doctor Looking at Healthcare Regulatory Updates

    Regulatory Deep Dives: Managing Healthcare Policy Changes

  • Female Medical Doctor PECOS User

    What is PECOS and its 7 Key Benefits?

  • In-House vs. Outsourced Credentialing. Two scenarios.

    Cost-Benefit Analysis: In-House vs. Outsourced Credentialing

  • Payer Contracting Experts Talking in a Healthcare Group HQ

    Payer Contracting: Maximize Your Rates

  • Credentialing Workflow Expert, a Latino Male Credentialer

    Smarter Workflows Reduce Credentialing Turnaround Time

  • Healthcare Organization Admins Talking, Walking

    ERAs vs. Real-Time Claim Status Checks: What’s the Difference?

  • Modifier 59 on screen, female medical coder

    How to Use Modifier 59 Correctly

  • White, Male, Medical Physician who is a CPT Coding Expert

    What’s New in 2026 CPT Coding: Essential Updates

  • Why (Average Revenue Per Encounter) Matters

  • Young, black male medical doctor looking to maximize his MIPS

    Are You Maximizing Your MIPS Performance?

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