Medical organizations need to be very careful when onboarding new practitioners. Not only should they make sure that a person has the necessary knowledge for a certain role, but they should also check if they have any restrictions. In the end, the last thing you need to do is hire a person who isn't currently allowed to practice medicine!
Due to this, credentialing can be a very arduous process. The healthcare organization has to check practitioners' past experience, educational background, certificates, and just about anything that would be relevant to their position. What's worse is that they have to be fast while doing it, as prolonged credentialing can lead to massive expenses and operational inefficiency.
Luckily, you can streamline the process by following the best practices. In this article, we’ll go through different things you can do to make your onboarding that much easier!
What is delegated credentialing?
As the name implies, delegated credentialing is a situation where a medical business, otherwise referred to as a health plan, hires an external company to help them with the credentialing process. Besides practitioner verification, the provider has the full authority to make any related decisions in favor of the company.
During the process, CVO (credentials verification organization) has to get in touch with various organizations to corroborate practitioners' data. Among others, they should reach out to their past employers, schools, and boards to see if the person can practice medicine in the US.
During credentialing, the provider will go through applicants' state licensure, certifications, CDS, board certification, work history, malpractice history, and other documents. Going through all these documents can be arduous, often leading to errors, especially when using data from various sources.
Luckily, CVOs can circumvent these problems by relying on their expertise and modern software. Most importantly, they can finish the entire procedure in a fraction of the time that medical organizations would take. They can also provide other benefits, such as eliminating micromanagement and ensuring full compliance.
Best delegated credentialing practices
Doing credentialing in-house can be extremely tricky, forcing you to invest money in a specialized team and software. Then again, hiring external partners does carry a fair share of challenges. Because of that, you need to be aware of different risks that you might encounter during your partnership.
Revise your needs
Before hiring a CVO, you need to thoroughly assess your needs. Smaller practices might require external assistance every now and then, while larger hospitals might have to work with credentialing providers on a regular basis. Whatever the case might be, you shouldn’t overpay for this service as it would defy its purpose.
It’s worth noting that most of these companies are flexible when signing contracts with their future clients. That being said, you should be wary when a company gives you an ultimatum and doesn’t want to meet your specific needs. In these situations, it’s much better to go to some other provider that can create a customized plan for your medical practice.
Ask for recommendations
When looking for a CVO for the first time, most companies start by combing online reviews or providers' websites. Unfortunately, this can be a bit misleading as many businesses invest heavily in PR texts. Some of them also use false testimonials and false statistical figures to manipulate public opinion.
Due to all of this, most companies have a limited number of legitimate online reviews. So, when looking for a potential partner, your best choice is to go with personal recommendations. Ask your friends from the healthcare industry who they would recommend and, after that, test them by using recommendations and best practices from this article.
Naturally, that doesn’t mean that online reviews are completely useless; just make sure to focus on reputable sources you can trust.
Learn more about software
For the most part, delegated credentialing hinges on a provider’s software. With these powerful tools, CVOs can streamline the process, avoiding potential errors, reducing onboarding time, and storing relevant documents. Healthcare credentialing software is particularly effective in automating key tasks such as expiration reminders, attaching links and documents as needed, and enabling staff to self-onboard and update their information. These features not only reduce administrative burden but also enhance accuracy and efficiency in credentialing workflows.
When assessing software, you need to take assess all sorts of features such as centralized credentialing, CAQH integration, workflow automation, CME tracking, notifications, electronic forms, peer review automation, and so on. You might also want to check if they have proprietary software or if they’re using someone else’s solution.
Of course, the software quality and versatility are just two of the numerous considerations you need to make. Nevertheless, given that the entire process will be streamlined with these programs, they can have a major impact on speed and end results.
Analyze their legal knowledge
To do this job, CVO's staff should have a high understanding of the legal framework. Although the laws change all of the time, these providers still need to have a solid basis that would guide them through the process.
The good thing is that it doesn't take much to determine if a person knows the current regulation. In fact, as a manager in a hospital or clinic, you should know lots of things about credentialing and medical compliance. By just asking a few questions, you can vet just about anyone, thus determining if a person is right for the job.
Consider their data processing
One of the reasons why credential verification is so complex is the sheer amount of documents that you need to process. Perhaps the biggest thing on the list is data storage. So, when choosing a provider, it's best to focus on organizations that use GDPR or General Data Protection Regulation.
The main focus of GDPR is operational control and accountability, ensuring that only specific users can access sensitive documentation. Another major thing you need to consider is how CVO tackles expiration dates. Ideally, you should look for providers that always know when recredentialing is due and can ensure that every practitioner has valid documents.
Conclusion
Based on everything mentioned in this article, it's obvious that choosing CVO is much more complex than you might think. Like with any other type of outsourcing, you need to find a partner that will keep your best interest in mind and are willing to go the extra mile to ensure everything is in order.
If you wish to learn more about credentialing or find a potential business partner, we suggest you clickhere!
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