| Hospital credentialing is the most intensive | | | | penalties.Credentialing verification |
| credentialing process for medical providers, | | | | organizations (CVO) allow hospitals to |
| repeated more frequently than other | | | | outsource the credentialing process for all |
| credentialing standards and involving more | | | | medical providers, such as physicians, |
| organization contacts and supporting | | | | respiratory therapists, X-ray technicians, |
| documents. The amount of staff time and the | | | | nurses, and mental health specialists. CVOs |
| expense of researching every medical provider | | | | dedicate resources and training to |
| can be heavy, draining resources from other | | | | credentialing, meaning personnel have |
| administrative functions, and requiring | | | | experience, comply with appropriate |
| experienced staff and access to research | | | | standards, and have access to verification |
| resources. Yet hospitals have been slower | | | | resources. Hospitals can better utilize their |
| than other medical organizations to outsource | | | | staff and finances, while lowering hospital |
| the credentialing process, despite potential | | | | liability for mistakes. Additionally, CVOs |
| benefits: faster turnaround time, | | | | can offer support services in addition to |
| cost-effectiveness, and savings in staff time | | | | credentialing which can make managing audits, |
| and training.Hospital credentialing covers | | | | renewing licenses, and other processes more |
| the most detailed questions of any | | | | efficient.There are minimum services that |
| credentialing standard, from medical school | | | | CVOs should offer to hospitals:Compliance |
| through the provider's complete career. The | | | | with JCAHO standards.Minimum number of |
| Joint Commission on Accreditation of | | | | contact attempts to and organization.Adapting |
| Healthcare Organizations (JCAHO) creates | | | | processes to incorporate hospital requests |
| manuals outlining the credentialing processes | | | | and specialized information |
| for all different medical providers within an | | | | requirements.Completed profiles with no |
| institution. The proscribed areas have to be | | | | sections left unverified.Improved turnaround |
| verified in ways that meet JCAHO standards. | | | | time, usually within 60 days.Quick committee |
| This entails direct contact with | | | | notification for problematic files. Fast |
| organizations associated with the provider, | | | | response to questions or problems.Web access |
| as well as receiving copies of all | | | | to profile reports and verification |
| certificates and licenses. All of these areas | | | | documentation, as well as hard copies.Quality |
| must be verified:DEA certificatesAll state | | | | CVOs offer other beneficial, |
| licenses and sanctionsMalpractice insurance | | | | resource-intensive services to |
| and claim historyTraining, internships, and | | | | hospitals:Surveillance between an initial |
| residenciesBoard certificationsMedical | | | | credentialing process and the first |
| educationAll past and current hospital | | | | recredentialing process for any disciplinary |
| privilegesWork history (verified through | | | | actions or sanctions.Routine notification for |
| direct contact)Medicare sanctions or | | | | recredentialing and expirable |
| opt-outsPeer referencesBoth the contact | | | | deadlines.Assistance during internal or |
| results and supporting documentation are | | | | external audits.Training and consulting for |
| gathered to create a final profile report for | | | | in-house credentialing.Using a CVO for |
| the provider, which is given to the | | | | medical provider credentialing saves |
| credentialing committee for review. Any | | | | hospitals time in staff hours, money and |
| warning signs or previous problems with the | | | | resources, and also offers support services, |
| provider must specifically be brought to | | | | such as audit support and surveillance of |
| committee attention.Most hospitals still do | | | | providers for sanctions or problems even |
| credentialing verification internally. If | | | | after completing credentialing, that a |
| they have full access to information | | | | hospital may not be able to maintain |
| resources and available money and manhours to | | | | internally. Hospital credentialing standards |
| dedicate staff, as well as having experienced | | | | are the tightest and most detailed of medical |
| personnel to do it, then in-house | | | | provider credentialing standards. CVOs can |
| credentialing can be as fast and thorough as | | | | remove the burden of meeting those standards |
| outsourcing it. Most hospitals do not have | | | | for hospitals through dedicated resources, |
| those resources or need to assign those | | | | experience, and support services.Physician |
| resources elsewhere. Moreover, hospitals bear | | | | Credentialing Solutions is a leading provider |
| the liability of any mistakes or oversights | | | | of credentialing verification services for |
| made during the credentialing process, and | | | | hospitals, PPOs and other health care |
| those mistakes can affect the results of | | | | organizations. |
| future audits, resulting in reprimands or | | | | |