What ACA health plans — and the employers and brokers who work with them — need to know about provider directory rules, and why “close enough” stopped being good enough a long time ago. Let’s start with the uncomfortable truth: a lot of ACA health plans are out there right now with provider directories that […]
Tag: provider roster
Credentialing Isn’t Paperwork. It’s the Backbone of Your Network.
Every health plan and every provider network has a credentialing function. Not every health plan and every network has a credentialing *system* — and the difference between those two things is where most of the downstream pain in this industry comes from. Credentialing is the gate. It determines who is permitted to bill the plan, […]