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MANAGED CARE RESOURCE TOOLKIT - NAMSS

MANAGED care RESOURCE TOOLKIT AUGUST 2017 Approved by NAMSS Board of Directors November, 2016 Revised August, 2017 1 Table of Contents Summary .. 2 MANAGED care Credentialing Metrics .. 3-4 MANAGED care Tool to Credentialing and Primary Source Verification .. 5-8 Practitioner Types .. 5 Verify License .. 5 Verify Board Certification .. 6 Verify Education and Training .. 6 Verify Work History .. 7 Verify Hospital Privileges .. 7 Verify Malpractice .. 7 Verify NPDB .. 7 Query Sanctions .. 8 Re-Credentialing .. 8 Concurrent Monitoring .. 8 Sample Credentialing Job Descriptions.

MANAGED CARE RESOURCE TOOLKIT AUGUST 2017 Approved by NAMSS Board of Directors November, 2016 Revised August, 2017

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