5 Tips for Effective Health Care Verification

You must be wondering why health care license verification is such a vital requisite for the practitioners. Well, it is done primarily for patient safety along with the healthcare organizations. It also ensures that healthcare services are up to the accredited standards, and there is no risk of overpayments. Complying with all the rules and regulation of the healthcare practices help the organization to run without a hitch.

So, here we have narrowed down some effective healthcare verification and monitoring tips for all organizations. These tips will serve as best practices for the services to ensure that all services comply with the given regulations under all circumstances.

1. Always follow the Rules of License Maintenance

In case you don’t know, license management is very critical for all healthcare facilities, institutions, and organizations. After a specified period, the health care license verification is done along with audits that are performed by the Joint Commission, Health & Human Services, and DNV. Some specific laws and standards need to be overlooked by the hospital authorities. It means overseeing the proof and documentation of the required licenses and certifications for the services they deliver.

Another requisition for the services is to account for the processes. It ensures that a person is qualified to handle the job appointed. The key intent behind this regulation is to lower the risk of fraudulent activities in the healthcare industry. These rules will prevent a person from acquiring invalid credentials to perform the duties of the medical and healthcare practice.

2. Go Beyond the Basics

Professional health care license verification and monitoring services like MedPro System handles the task of ensuring that the licenses are renewed and documented correctly. They verify the changed, modified, and renewed board actions and ensure that all the recent changes are implemented optimally. Most of the facilities in the United States of America are using an outdated license management process which needs to be transformed.

With the help of the MedPro System, you can boost the performance measurement of the organizations while checking out the regulatory compliance as well. It is the Office of Inspector General (OIG) that lists the exclusion and inclusion of the individuals in all facilities.

3. Identify the Problem of Overpayments

Recently, there have been many cases of overpayment in the Medicare industry. The issue of the overpayment is more significant than you realize, and it pertains to the practitioners with an expired license. It leads to a heightened need for improvement in the verification process. Under the rules of license verification, if the practitioner continues to practice medicine after license expiration, that’s when overpayment occurs. And the Patient Protection & Affordable Care Act (PPACA) keeps the practitioner under the obligation to return the overpayment within 60 days. Otherwise, he or she will be charged from the Civil Monetary Penalty.

4. Create a Centralized Process

Health Care License VerificationServices have Another crucial aspect. It includes the centralization of the processes within a healthcare facility. Centralization brings in oversight, accountability, and control over the major and minor process undergoing within. A regular patient might not know this, but hospital processes vary from one hospital to another, and the methods are also different such as payroll systems, HRIS systems, etc. As long as the Joint Commission is accredited, they expect you to update the process frequently. A lapse in the process will affect your accreditation.

That’s the main reason why many organizations rely on MedPro to obtain license verification for health services. When knowledgeable professionals are looking over the credentials and licenses for the practitioners, they don’t have to worry about maintaining their current license status.

5. Third-Party Participation

It might be the most useful tip to follow if you want to make sure that your organization runs smoothly. Third-party credentialing assists the services with the overwhelming task of managing the professional licenses of their staff members. Various critical factors must be considered before you choose a Health Care License Verification Service.

So, take a look at these points and then make your decision:

  • Consider the current hospital policies that pertain to licenses and also run an analysis of how a third-party involvement will affect those policies as they get intertwined in the organization.
  • Make sure that the third-party is flexible enough to understand the current licensure status and compliance relevant to your industry. The health care license verification is a critical and prominent subject matter to handle for a successful partnership.
  • As the current payroll system and HRIS system is being upgraded in many healthcare facilities, the third-party license verification service needs to accommodate these changes and ensure continuity of the service without any delay.
  • Another added factor while determining the third-party licensing and verification service is up to par is technical experience and familiarity with integrations. The party needs to keep a separate database for license management, which can be done optimally by experts-only.

Having your medical license confiscated because of simple negligence of documents can cost you a lot. That’s why all individuals in the medical industry need to make sure personally and professionally that their license is up-to-date. Now, nobody can skip the Health Care License Verification process and be involved in fraudulent activities.

Lucky for you, MedPro Systems keeps a database that contains relevant information about all the licensed healthcare practitioners in the United States of America and Puerto Rico. We understand that knowing that you are under professional and experienced supervision can make a huge difference in the quality of services. Hence, MedPro Systems are dedicated to delivering highly effective health care license verification for the safety of the patients.


Sudarsan Chakraborty is a professional writer. He contributes to many high-quality blogs. He loves to write on various topics.