| Quality credentialing verification
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| | evaluating bad practice. The CVO should
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| organizations (CVO's) create an
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| | be able to supply a copy of their quality
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| environment beyond simply generating
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| | control policies and practices
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| credentialing reports for medical
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| | documentation. If they are accredited by
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| providers. A CVO with good customer
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| | NCQA or URAC, then there is a guarantee
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| service responds quickly to questions;
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| | that these practices have been reviewed
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| has trained staff that is assigned to a
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| | and audited and that their service meets
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| particular client; can streamline the
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| | industry standards.High quality services.
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| credentialing process; has good
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| | Two attributes of quality work are
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| technology resources; and offers extra
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| | timeliness and thoroughness. Good CVOs
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| support, such as internal audits and
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| | will return credentialing reports as
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| tracking license renewals. An emphasis on
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| | quick as industry norms, meaning around
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| customer service means that the CVO can
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| | 60 days for hospital standards (JCAHO)
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| supply substantive information and
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| | and 30 days for managed care standards
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| support to establish a true working
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| | (NCQA and URAC). The credentialing
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| relationship with a medical
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| | reports will also be complete - no
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| organization.There are five areas of a
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| | missing data or criteria and with full
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| CVO's customer service to consider:
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| | supporting documentation. CVOs should
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| flexible credentialing processes which
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| | have an established maximum number of
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| can be adapted in response to client
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| | requests they make to organizations for
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| needs; a range of quality services; quick
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| | information and other avenues of finding
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| responses to clients; individual support;
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| | information. Problem files should be
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| and solid technology practices. Although
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| | brought immediately to the review
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| some service points, such as a fast
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| | committee's attention. All of these
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| response to questions, can seem small,
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| | practices work together to make a
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| these areas display the quality of the
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| | thorough credentialing
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| CVO, which will define the long-term
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| | report.Additionally, good CVOs offer
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| relationship between the CVO and its
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| | services such as tracking licensing dates
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| clients.Adapting credentialing services
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| | and requirements (expirables) and
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| to client needs.
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| | disciplinary actions by various
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| CVOs should be responsive to their
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| | organizations (surveillance); consulting
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| clients' needs. The CVO should be
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| | and training classes about credentialing
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| accredited by either accrediting
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| | processes; and support during internal
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| organization: National Committee for
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| | audits.Quick response to client contact.
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| Quality Assurance (NCQA) or the
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| | Good CVOs respond to questions within 24
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| Utilization Review Accreditation Councile
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| | hours. They should answer any questions
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| (URAC) or comply with their
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| | fully and as quickly and directly as
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| credentialing standards. In addition, the
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| | possible rather than postponing or
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| CVO should add new credentialing
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| | transferring them.Technology resources.
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| standards for their clients and should
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| | CVOs should be using the most recent
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| also be able to adapt their credentialing
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| | technology, such as databases, paperless
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| processes by adding special criteria or
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| | credentialing, and web access with
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| using a subset of criteria. This
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| | adequate security and access
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| flexibility includes making
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| | control.Customer service is key to
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| recommendations to streamline processes
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| | creating a good relationship between CVOs
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| and working with clients to determine
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| | and medical organizations. Quality
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| what they need rather than following a
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| | control policies, flexible credentialing
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| preset checklist.Individualized support
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| | processes and criteria, quick response
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| and quality controls.
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| | time, good technology use, and
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| Individualized service means that there
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| | responsiveness to questions and requests
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| is a dedicated representative for each
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| | are five major areas where a CVO develops
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| client. There should be a known manager
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| | good customer relations. All these areas
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| to handle difficult situations and an
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| | mean the CVO is responsive - that the CVO
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| established route to lodge complaints.
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| | is paying attention to individual
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| All personnel should be trained to
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| | customer needs and consistently doing its
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| perform credentialing reports according
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| | best to meet them.Physician Credentialing
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| to the accrediting organization's
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| | Solutions is a leading provider of
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| standards.There should also be an
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| | credentialing verification services for
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| established quality control system and
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| | hospitals, PPOs and other health care
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| regular internal audits for managing
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| | organizations.
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| feedback, rewarding good service, and
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