# Credentialing * **Definition:** The process of verifying the qualifications and professional background of healthcare providers to ensure they meet the necessary standards for practice. * **Taxonomy:** Healthcare Topics / Credentialing ## News * Selected news on the topic of **Credentialing**, for healthcare technology leaders * 3.1K news items are in the system for this topic * Posts have been filtered for tech and healthcare-related keywords | Date | Title | Source | | --- | --- | --- | | 5/2/2025 | [**Streamlining Healthcare Excellence: A Comprehensive Guide to Medical Credentialing Services**](https://healthcareguys.com/2025/05/02/streamlining-healthcare-excellence-a-comprehensive-guide-to-medical-credentialing-services/?utm_source=rss&utm_medium=rss&utm_campaign=streamlining-healthcare-excellence-a-comprehensive-guide-to-medical-credentialing-services) | [[The Healthcare Guys]] | | 3/31/2025 | [**MedTrainer Is Setting the Pace in Healthcare Credentialing Software With Industry-Leading ...**](https://www.prweb.com/releases/medtrainer-is-setting-the-pace-in-healthcare-credentialing-software-with-industry-leading-innovations-302413959.html) | [[PRWeb]] | | 2/24/2025 | [**QGenda Streamlines Credentialing at MyMichigan Health to Drive Operational Efficiency ...**](https://www.morningstar.com/news/business-wire/20250220921321/qgenda-streamlines-credentialing-at-mymichigan-health-to-drive-operational-efficiency-and-improve-patient-access) | [[Morningstar]] | | 2/24/2025 | [**QGenda Streamlines Credentialing at MyMichigan Health to Drive Operational Efficiency**](https://hitconsultant.net/2025/02/24/qgenda-streamlines-credentialing-at-mymichigan-health-to-drive-operational-efficiency/) | [[HIT Consultant]] | | 2/14/2025 | [**What You Need to Know About the Vendor Credentialing Market in 2025**](https://www.beckershospitalreview.com/cybersecurity/what-you-need-to-know-about-the-vendor-credentialing-market-in-2025.html) | [[Beckers Hospital Review]] | | 2/5/2025 | [**Applied Statistics and Management Inc.'s MD-Staff Earns Fifth Consecutive Best in KLAS Award for Credentialing**](http://www.businesswire.com/news/home/20250205581701/en/Applied-Statistics-and-Management-Inc.%E2%80%99s-MD-Staff-Earns-Fifth-Consecutive-Best-in-KLAS-Award-for-Credentialing/?feedref=JjAwJuNHiystnCoBq_hl-RLXHJgazfQJNuOVHefdHP-D8R-QU5o2AvY8bhI9uvWSD8DYIYv4TIC1g1u0AKcacnnViVjtb72bOP4-4nHK5ieT3WxPE8m_kWI77F87CseT) | [[Business Wire]] | | 1/24/2025 | [**The future of provider credentialing: Where are we headed?**](https://www.beckersasc.com/asc-accreditation-and-patient-safety/the-future-of-provider-credentialing-where-are-we-headed.html) | [[Beckers ASC Review]] | | 1/14/2025 | [**MedTrainer and Propelus Announce Strategic Partnership to Revolutionize Provider Credentialing**](https://www.prweb.com/releases/medtrainer-and-propelus-announce-strategic-partnership-to-revolutionize-provider-credentialing-302350243.html) | [[PRWeb]] | | 12/20/2024 | [**Streamlined Credentialing: The Secret to Smarter Healthcare - by Medical Billing Buzz**](https://medium.com/@medical-billing-buzz/streamlined-credentialing-the-secret-to-smarter-healthcare-bfa8d7fddff9) | [[Medium]] | | 12/13/2024 | [**The Role of DLT in Cross-Border Healthcare Data Sharing**](https://hitconsultant.net/2024/12/13/the-role-of-dlt-in-cross-border-healthcare-data-sharing/) | [[HIT Consultant]] | | 12/5/2024 | [**“Harnessing Technology for Quality Improvement in Indian Healthcare Organizations” - by Amrutha**](https://medium.com/@amrutha_41286/harnessing-technology-for-quality-improvement-in-indian-healthcare-organizations-50e07babc35f) | [[Medium]] | | 11/26/2024 | [**symplr Earns Third #1 Black Book Ranking in 2024 for Provider Data Management & Credentialing**](https://www.prweb.com/releases/symplr-earns-third-1-black-book-ranking-in-2024-for-provider-data-management--credentialing-302316117.html) | [[PRWeb]] | | 11/25/2024 | [**The Case for a “Single Source of Truth” in Provider Credentialing**](https://medcitynews.com/2024/11/the-case-for-a-single-source-of-truth-in-provider-credentialing/) | [[MedCity News]] | | 11/14/2024 | [**PMG Credentialing, Inc. Receives NCQA Accreditation in Credentialing/Recredentialing**](https://www.prnewswire.com/news-releases/pmg-credentialing-inc-receives-ncqa-accreditation-in-credentialingrecredentialing-302306041.html) | [[PR Newswire]] | | 11/10/2024 | [**ALIGNMT AI and HFMA Collaborate to Offer AI Governance Micro-Credentialing for ...**](https://www.prnewswire.com/news-releases/alignmt-ai-and-hfma-collaborate-to-offer-ai-governance-micro-credentialing-for-healthcare-professionals-302295869.html) | [[PR Newswire]] | | 10/24/2024 | [**Credentialing software helps Bozeman Health reduce turnaround times, reallocate 2 FTEs**](https://www.healthcareitnews.com/news/credentialing-software-helps-bozeman-health-reduce-turnaround-times-reallocate-2-ftes) | [[Healthcare IT News]] | | 8/28/2024 | [**Advanced Provider Data Management Technolgies Drive 2025 Credentialing Systems ...**](https://www.bignewsnetwork.com/news/274531414/advanced-provider-data-management-technolgies-drive-2025-credentialing-systems-overhaul-black-book-user-survey) | bignewsnetwork.com | | 8/21/2024 | [**Simplify Healthcare Unveils Advanced Credentialing Solution with Provider1 ... - Morningstar**](https://www.morningstar.com/news/business-wire/20240821431828/simplify-healthcare-unveils-advanced-credentialing-solution-with-provider1credentialing) | [[Morningstar]] | | 8/21/2024 | [**Simplify Healthcare Unveils Advanced Credentialing Solution with Provider1 ... - Yahoo Finance**](https://finance.yahoo.com/news/simplify-healthcare-unveils-advanced-credentialing-142400604.html) | [[Yahoo Finance]] | | 8/21/2024 | [**Simplify Healthcare Unveils Advanced Credentialing Solution with Provider1™.Credentialing**](https://www.businesswire.com/news/home/20240821431828/en/Simplify-Healthcare-Unveils-Advanced-Credentialing-Solution-with-Provider1%E2%84%A2.Credentialing/) | [[Business Wire]] | | 8/21/2024 | [**Simplify Healthcare Unveils Advanced Credentialing Solution with Provider1™.Credentialing**](http://www.businesswire.com/news/home/20240821431828/en/Simplify-Healthcare-Unveils-Advanced-Credentialing-Solution-with-Provider1%E2%84%A2.Credentialing/?feedref=JjAwJuNHiystnCoBq_hl-RLXHJgazfQJNuOVHefdHP-D8R-QU5o2AvY8bhI9uvWSD8DYIYv4TIC1g1u0AKcacnnViVjtb72bOP4-4nHK5ieT3WxPE8m_kWI77F87CseT) | [[Business Wire]] | | 8/21/2024 | [**Simplify Healthcare Unveils Advanced Credentialing Solution with Provider1™.Credentialing**](http://www.businesswire.com/news/home/20240821431828/en/Simplify-Healthcare-Unveils-Advanced-Credentialing-Solution-with-Provider1%E2%84%A2.Credentialing/?feedref=JjAwJuNHiystnCoBq_hl-Q-tiwWZwkcswR1UZtV7eGe24xL9TZOyQUMS3J72mJlQ7fxFuNFTHSunhvli30RlBNXya2izy9YOgHlBiZQk2LOzmn6JePCpHPCiYGaEx4DL1Rq8pNwkf3AarimpDzQGuQ==) | [[Business Wire]] | | 8/9/2024 | [**Acorn Credentialing to Showcase Cutting-Edge Credentialing Solution at NACDS Event**](https://www.prnewswire.com/news-releases/acorn-credentialing-to-showcase-cutting-edge-credentialing-solution-at-nacds-event-302219223.html) | [[PR Newswire]] | | 2/19/2024 | [**How Claimocity scaled their revenue cycle management with Modio's provider credentialing platform**](https://www.beckersasc.com/asc-transactions-and-valuation-issues/how-claimocity-scaled-their-revenue-cycle-management-with-modio-s-provider-credentialing-platform-2.html) | [[Beckers ASC Review]] | | 1/14/2024 | [**Avoid 8 Common Physician Credentialing Pitfalls**](https://www.healthleadersmedia.com/clinical-care/avoid-8-common-physician-credentialing-pitfalls) | [[HealthLeaders Media]] | ## Topic Overview (Some LLM-derived content — please confirm with above primary sources) ### Key Players - **Certify**: A provider of automated credentialing solutions that emphasizes the importance of data accuracy and system integration to reduce administrative costs. - **NCQA**: National Committee for Quality Assurance, setting updated credentialing standards for healthcare organizations. - **PMG Credentialing, Inc.**: A company that has earned NCQA Accreditation in Credentialing and Recredentialing, showcasing its commitment to high industry standards in healthcare provider credentialing. - **Acorn Credentialing**: A provider of automated credentialing solutions that aims to enhance operational efficiency in the pharmacist credentialing process. - **Simplify Healthcare**: Launched Provider1™.Credentialing, an advanced solution designed to streamline the provider credentialing process for health insurance companies. - **Sosa Practice Partners**: Offers tailored solutions to help healthcare organizations streamline credentialing processes. - **QGenda**: A provider of scheduling and credentialing solutions that enhances operational efficiency and reduces credentialing time. - **symplr**: Recognized as the top-ranked credentials verification organization (CVO) service, providing provider data management and credentialing solutions for healthcare systems and payers. - **ProviderTrust**: A leader in healthcare data integrity, specializing in credentialing and data verification to ensure compliance and reduce administrative burdens. - **Certify Health**: Developed a provider data intelligence platform that automates and streamlines the credentialing process, significantly reducing time from months to minutes. - **Medallion**: An AI-powered platform that enhances automated credentialing and privileging capabilities, ensuring compliance and optimizing workforce efficiency. - **National Committee for Quality Assurance (NCQA)**: An organization updating credentialing standards for 2025 to align with evolving healthcare needs. - **Modio Health**: A company that streamlines healthcare provider credentialing through advanced technology. - **HealthStream**: A healthcare technology platform that offers solutions for credentialing, privileging, and enrollment, including the CredentialStream solution. - **Green Security LLC**: A company focused on providing advanced security solutions for healthcare facilities, including credentialing software. - **MedTrainer**: A company revolutionizing credentialing technology with AI-driven automation and real-time license verification to streamline provider onboarding. ### Partnerships and Collaborations - **MedTrainer and Propelus**: A strategic partnership to enhance provider credentialing through automated primary source verifications and monitoring. - **HealthStream and Verisys Corporation**: Collaborating to automate payer credentialing and regulatory compliance. - **ProviderTrust and various healthcare organizations**: ProviderTrust's DynamicNPI solution provides verified provider profiles, enhancing credentialing efficiency. - **QGenda and MyMichigan Health**: Implemented QGenda's Credentialing solution, significantly improving operational efficiency and reducing credentialing time. - **MyMichigan Health and QGenda**: Implemented QGenda's credentialing solution to reduce credentialing turnaround time by 50% and improve operational efficiency. - **ALIGNMT AI and HFMA**: Collaboration to launch a micro-credentialing program focused on AI governance skills for healthcare professionals. - **MetLife and SKYGEN**: Integrated SKYGEN's Dental Hub to centralize credentialing processes for dental providers. - **HealthStream and Verisys**: Collaboration to offer a data-driven solution for health plans that automates payer credentialing and regulatory compliance. - **Healthcare Administrative Partners (HAP) and Imaging Healthcare Specialists (IHS)**: Partnering to provide revenue cycle management services, including credentialing. - **Modio Health and CHG Healthcare**: Modio Health was acquired by CHG Healthcare in 2019, enhancing its capabilities in healthcare provider credentialing. - **Trio VMS and IntelyCare**: Announced a strategic partnership to provide healthcare facilities with on-demand access to credentialed clinicians. - **Global Healthcare Exchange (GHX) and RepScrubs**: Integration to enhance compliance in perioperative attire for vendors in hospitals and surgery centers. - **Retrieve Medical Holdings and Curatus LLC**: Signed a Letter of Intent for acquisition to enhance healthcare portfolio and operational efficiencies. - **Madaket Health and ProviderTrust**: A strategic partnership aimed at improving provider data accuracy and reducing administrative burdens in the payer-provider ecosystem. - **Nsight Health and Physicians Choice Medical**: Collaborating to enhance Remote Patient Monitoring and Chronic Care Management services. - **FirstHealth of the Carolinas and CareRev**: Partnered to enhance workforce strategy by connecting with a qualified, on-demand healthcare workforce. - **Aya Healthcare and AAPPR**: Aims to enhance physician and provider recruitment through technology, addressing workforce challenges in healthcare. ### Innovations, Trends, and Initiatives - **Centralized Credentialing Database**: A proposed centralized, continuously updated database for provider credentialing to improve trust and accessibility across the healthcare sector. - **Provider1™ Credentialing**: An automated solution by Simplify Healthcare aimed at improving compliance and efficiency. - **Delegated Credentialing for Telehealth**: A standard practice allowing hospitals to rely on credentialing decisions from distant sites, improving efficiency in telehealth services. - **Digital Credentialing Solutions**: Transition from paper-based processes to cloud platforms and real-time verification systems, improving efficiency and effectiveness. - **NCQA 2025 Standards**: Emphasizing robust reporting and analytics in healthcare credentialing, requiring real-time verifications. - **CAQH**: Proposed a universal roster to streamline the credentialing process and reduce administrative burdens. - **Ceipal Healthcare Platform**: Designed to streamline recruitment and automate compliance, including credential management. - **Incredable™ Rebranding**: Formerly Ready Doc, now focusing on simplifying the credentialing process with enhanced technology. - **CredentialStream Privilege Solution**: A patented solution by HealthStream that automates the evaluation of healthcare provider qualifications. - **CredentialStream Enhancements**: HealthStream introduced new features to its CredentialStream solution, improving credentialing efficiency and provider experience. - **AI in Credentialing**: Mercy Health System implemented an automated nurse-credentialing system to address workforce challenges. - **Automation in Credentialing**: Automation has reduced credentialing turnaround times from 90-120 days to 40-45 days, increasing the number of applicants credentialed per month significantly. - **CredentialStream Platform Enhancements**: HealthStream introduced new features in its CredentialStream platform, including a mobile wallet for pre-validated credentials. - **American Nurses Credentialing Center (ANCC) Initiative**: A program to empower nursing professionals and improve patient care in high-need communities through financial support for credentialing. - **Simplify Healthcare**: Launched an innovative credentialing solution featuring automated primary source verification and AI-driven accuracy. - **Mobile Wallet for Credentials**: HealthStream's hStream for Credentialing package offers a mobile wallet of pre-validated credentials for providers, streamlining application processes. - **NCQA Credentialing Standards Update**: Updating standards for 2025 to improve quality assurance in healthcare operations. ### Challenges and Concerns - **Credentialing Compliance**: Healthcare organizations face challenges in meeting updated NCQA standards, including license monitoring. - **Compliance Issues**: Improper implementation of delegated credentialing may lead to compliance issues, necessitating careful management. - **Complex Credentialing Processes**: Current credentialing processes are cumbersome and time-consuming, often taking up to six months, which exacerbates health inequities. - **Regulatory Compliance**: The credentialing industry faces challenges in adapting to regulatory changes and maintaining a single source of truth for credentialing data. - **Credentialing Inefficiencies**: The credentialing process is often time-consuming and costly, with significant redundancy and inefficiency due to lack of data sharing between hospitals. - **Legal Issues in Credentialing**: A lawsuit filed by Karina Mejias highlights potential retaliatory actions related to credentialing oversight. - **Administrative Burden**: Credentialing processes can be slow and costly, leading to compliance challenges and jeopardizing patient safety. - **Data Privacy and Security**: Ensuring data privacy and security in credentialing processes is critical, as highlighted by ProviderTrust's HITRUST certification. - **Data Security and Privacy**: Concerns regarding the protection of sensitive health information in the transition to digital credentialing. - **Inefficiencies in Credentialing**: Many healthcare organizations still rely on outdated methods, leading to compliance gaps and potential revenue loss. - **Inefficiencies in Traditional Credentialing**: Outdated processes lead to security gaps and inefficiencies, necessitating technology-driven solutions for improvement. - **Staffing Shortages**: Healthcare organizations face staffing shortages that complicate credentialing processes and referral placements. - **Market Consolidation**: The vendor credentialing market is experiencing consolidation, raising concerns about rising costs, reduced innovation, and diminished customer focus. - **Data Breaches in Credentialing**: Healthcare organizations face risks from unauthorized access to patient data, with third-party vendors responsible for a significant percentage of breaches. - **Mental Health Stigma**: Credentialing processes often include invasive questions about mental health, creating barriers for healthcare workers seeking care. - **Complexity for Independent Contractors**: The shift towards independent contracting complicates the credentialing process, often lacking adequate support. - **Compliance Costs**: High certification costs for small and medium enterprises (SMEs) can hinder adoption of credentialing standards. - **Data Security Risks**: With the increase in credentialing requests and sensitive data handling, healthcare organizations face heightened risks of security breaches. - **High Turnover Rates**: The healthcare industry faces challenges such as high turnover rates and rising costs, impacting credentialing processes. - **Adena Health NCQA Denial**: Adena Health faced denial of accreditation for not meeting NCQA standards, highlighting the importance of compliance in credentialing.