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7 Must-have Features in a Credentialing Management Software in 2022



Credentialing in healthcare is a defined process that reviews the physician’s qualifications, specialty certificates, education, training, residency, licenses, etc. Health care credentialing software simplifies this process by automating manual verification, data screening, contracts generation, application management, and other tasks. Custom healthcare solutions in credentialing can optimize operations and workflows, prepare healthcare facilities for audits, securely store updated provider’s data, and ensure these accreditations are easy to find. Credentialing software also automates the time-consuming and cumbersome credentialing process with centralized and compliant credentialing. Finally, credentialing solutions provide patients with updated and accurate provider information.   

An integral part of the medical billing process – credentialing – is becoming a trusted healthcare provider with an insurance company. If done correctly, it will allow the healthcare organizations to be listed on an insurer’s network. Every insurance provider forms a rigorous set of requirements that healthcare organizations must meet to make it into their listing. Making it into this list will allow the health facility access to an expanded patient base, to whom they can then offer mHealth technologies. The medical billing credentialing process is the primary source of verification, wherein the insurance company conducts a background check on the healthcare provider.   

Challenges with Manual Credentialing Systems

Low Portability: Lower portability adversely affects the process workflow and data management tasks in credentialing.  Manual Process: A paper-based and manual credentialing process is detrimental to the speed and efficiency of credentialing.  Data Management: Inefficient management of data storage, data segmentation, data security for better credentialing.  High Error Ratio: Due to manual and paper-based systems, there is a high error ratio in the credentialing process.  Noncompliance: Inability to maintain NCQA compliance for a seamless and secure credentialing process causes inefficiencies.   Credential Expiration: Inability to manage and control the healthcare credentialing process without proper reminders.  

7 Must-Have Features in Credentialing Management Software

1. Centralized Credentialing:

Centralized credentialing is the process of improving credentialing efficiency and eliminating repetitive tasks through healthcare provider’s solutions. Credentialing solutions, in this way, boost revenue cycle management and stay competitive. Medical credentialing software has a great effect on provider data integrity and in facilitating delegation with payers. Two or more healthcare facilities share credentialing providers’ costs with centralized credentialing, saving the total cost required via electronic data exchange solutions.  

Even the providers get one opportunity for healthcare compliance credentialing, making the process more hassle-free and increasing the goodwill between providers and administrators. Customizing credentialing management software for hospitals help in delegating relationship with payers to optimize revenue cycle management and decrease the overall expenses. Centralized credentialing solutions are tailored to eliminate the process of credentialing a single provider across multiple systems while maintaining the efficiency and data integrity of credentialing through HIPAA compliance.  

2. Work Flow Automation:

Healthcare credentialing is a time-consuming and cumbersome process. It includes collecting required data from the physicians, developing the credentialing strategy, auditing the provided data for accuracy, validating the data & certificates, managing provider profiles, and following up with payers. Medical credentialing companies customize healthcare credentialing software to replace the manual credentialing workflow. Moreover, cloud computing in healthcare can be applied to credentialing software to offer real-time, intuitive dashboards that enhance productivity and eliminate the redundancy of the process.  

Healthcare credentialing companies can create automated workflows to offer a seamless process for online verification, attestation aging, expiration management, credentialing metrics, onboarding options, etc. Therefore, healthcare credentialing software uses healthcare automation across the entire workflow of credentialing medical providers to boost monitoring and maximize the credentialing process performance.  

3. Demographic Analysis:

Medical provider credentialing software provides an insight view of the process, workflow, and credentialing process at a specific healthcare facility. The cloud-based data storage and data management feature help maintain the optimum quality of the gathered data securely through electronic health records. Healthcare provider credentialing software replaces the practice of maintaining the myriad of spreadsheets and files to store all your credentialing data and apply it toward population health management.  

Multi-tier database hierarchy, intuitive database population, and timely provider and payer updates help you develop an advanced credentialing infrastructure where data is segmented based on the healthcare facility, groups within the facility, locations, departments, and provider specialties. Physician credentialing companies can apply these software solutions to display how credentialing services should operate to provide maximum success.  

4. Online Verification:

Online provider verification is among the essential healthcare services of a credentialing management system that streamline the process of online validation of the provider’s submitted credentials and certificates. Cutting-edge cloud medical credentialing services help assess and acquire accurate, current information regarding physicians and health care providers, including nurse practitioners, labs, and skilled health nursing facilities. Medical staff credentialing solutions render highly comprehensive and robust online background verification tools.  

Through clinical data analysis and clinical informatics solutions, credentialing software can create a quality background verification system that is fully automated and uses multiple manual verification features to authenticate and validate the crucial credentials of providers. Finally, healthcare analytics solutions efficiently run complete background checks and smartly manage their detailed investigations with facial, social security, ID, etc.  

5. Automated Alerts:

Healthcare facilities constantly need updated providers’ data and credentials. The expiration reminders and automated alerts for credentialing in medical billing help keep track of documents and certificates that are about to expire and changes in performance metrics. Custom credentialing in medical billing tracking software helps in providing complete visibility in the provider’s profile with smart notification settings and automated email reminders through integrated healthcare systems.  

The automated alerts offered by custom facility credentialing software have helped to up the performance of the credentialing process, and in turn, the facility by notifying users in advance through integrated care management. These timely notifications prove useful when the credentialing documents, licenses, certifications, and more are due to expire and need attention. The automated alerts can be configured to report the specific staff responsible for resolving the issue automatically.  

6. Comprehensive Reporting:

To boost the workflow process of facility credentialing software, healthcare interoperability needs to go beyond standard reporting. Unlimited, intuitive, and comprehensive credentialing reports to quickly recover insightful data and customize reports in various formats. Just as it is with medical records management, cutting-edge insurance credentialing management software is customized to create tailored reports using an ad-hoc report writer.  

The medical credentialing process tracking software incorporates top-quality reporting features, including institutional summary, days in enrollment, facility summary, provider summary, and more. A robust credentialing management software program’s made-to-order solutions provide a comprehensive library of ad-hoc reporting, built-in reports, summary management reports, tickler reports, board certification, and reappointment data.  

7. Data & Network Management

Managing complex and tiered provider networks is a crucial challenge. Credentialing management software promotes hassle-free and automated providers’ data and network management. Through intuitive healthcare credentialing platforms, streamlined workflow, and data repositories, credentialing software solutions align contracts, provider demographics, specialties, fee schedules, etc. Managing and tracking credentialing activity in real-time, optimizing financial contract optimization, and standardizing historical claims are the major functionalities of customized credentialing software.  

A strong foundation of accurate and optimized data analytics is the most crucial element of credentialing management. Data accuracy allows for sound assessments, opportunity tapping for improvements, and progress measurement. Healthcare credentialing solutions, just like patient engagement systems, aim to use data-building techniques to reduce performance disparities.   


Credentialing for healthcare requires advanced technological support. Developing an advanced telehealth solution that is tailor-made to the specific healthcare organization’s need is the ideal choice. These solutions can provide a robust mechanism and undertake complex credentialing duties with ease and proficiency. The health facilities credentialing quality will be superior and most hassles evaded for administrative staff. Finally, there is plenty of scope for customer support and updates based on future requirements.   

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Ohio Receives 175,000 COVID-19 Test Kits Through Partnership



Columbus, Ohio — Dr. Bruce Vanderhoff, Director of Health, Ohio, announced on Wednesday that more COVID-19 rapid tests will be available in Ohio thanks to the new partnership.

According to the release, the Rockefeller Foundation has participated in six states through the Project Access COVID test, making the test available to homes in poorly serviced areas.

The partnership’s first Ohio quota is 175,000 tests, which will be available for courier.

In its release, Dr. Vanderhoff said Ohio was one of the first states to ensure that free rapid testing was widely available. Over 5 million kits have been purchased and distributed to schools, libraries and community health departments.

“Because of the rapid shortage of tests nationwide, this partnership with the Rockefeller Foundation will help increase access to tests for high-risk people and reduce their spread in our community,” Vander said. Dr. Hoff said.

Ohio receives 175,000 COVID-19 test kits through partnership

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Governor Mike Dewein Discusses New Intel Facility




The project will create more than 20,000 jobs in the state.

Columbus, Ohio — Ohio authorities are discussing incentives in a decision to bring two new Intel chip manufacturing facilities to the state.

The briefing is hosted by Ohio State Development Director Lydia Miharik. You can see it on the following players:

DeWine announced a $ 20 billion investment last week, calling it “monumental news for Ohio.”

The project will create more than 20,000 jobs in the state. This includes 3,000 direct Intel jobs and 7,000 construction jobs during the build process.

Overall, the project is expected to add $ 2.8 billion to Ohio’s total annual production.

“The new plant in Ohio is part of a strategy to increase semiconductor R & D and global manufacturing capacity and restore leadership in the US semi-manufacturing industry,” said Intel CEO Pat Gelsinger. Says. “Intel Ohio expects to become one of the world’s largest semiconductor manufacturing sites over the next decade.”

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Governor Mike Dewein discusses new Intel facility

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Contribution of Verbs to the Webb Telescope Discussed at the Lima Astronomical Society on February 4th



LIMA — Robert Verb presents a $ 10 million James Webb Space Telescope’s beryllium mirror segment process and engineering involvement multimedia program at the Lima Astronomical Society meeting on Friday, February 4th.

The meeting was at 8 pm at 670 N. Jefferson St in Lima. It starts at the Schoonover Observatory in the Schoonover Park.

Verb is a former US Army officer and graduate of the Faculty of Engineering at the University of Toledo. He was responsible for providing the correct chemical mixture, processing the material, and following up with the machining of beryllium mirrors and shipping to NASA.

Lima Astronomical Society: 8 pm, 670 N. Jefferson St in Lima. Schoonover Observatory in Schoonover Park. Robert Verb presents his contributions to the Webb Telescope.

Contribution of verbs to the Webb Telescope discussed at the Lima Astronomical Society on February 4th

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