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How Healthcare Organizations Stay Credentialing Compliant

Questioner

Sangeeta, how do healthcare organizations ensure compliance with credentialing regulations?

Sangeeta

Compliance is maintained by staying current with the guidelines set by organizations like the Joint Commission, the National Committee for Quality Assurance, and state medical boards. This involves regularly reviewing and updating credentialing policies, conducting internal audits, and ensuring that all healthcare providers meet both state and federal licensing requirements. 

Healthcare organizations also need to ensure they are following the CMS requirements if they wish to participate in Medicare or Medicaid programs.

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