Blog /

Credentialing Automation Brings Benefits to your Team and Bottom Line



Whether your credentialing is being managed by an internal team of specialists, outsourced to a certified CVO, or some combination of these, credentialing is not just a necessary administrative burden, it’s an opportunity for cost savings and increased revenue generation. That’s it. That’s the post.

But let me explain.

The Age of Automation Meets Credentialing

Automation can be a scary buzzword to a lot of people. Fear that it is replacing people, “taking” jobs, taking over the planet. These are all legitimate fears (except for maybe that last one). But we also see places where automation has transformed industries and functions for the better. Places where jobs are difficult to fill, where tasks are painfully slow and tedious, where human error can cause outsized problems.

Credentialing is one of those functions. People have been doing a great job of getting credentialing done in a systematic way for over half a decade already. At the time that credentialing became popularized and legally required in the medical community, the tools available were limited to primarily analog technology. We’re talking snail mail, fax machines, couriers, all of those old-timey methods for passing information from one source to another. Many of the more experienced credentialers in the industry remember a time when this process was done exclusively on paper. A lot of other processes were done on paper back then too, but now they’re not.

Automation has entered the credentialing scene, and it’s making work better for people who have been in the credentialing industry for decades. Now, instead of manually performing Primary Source Verifications (PSVs), credentialing teams can spend more time putting finishing touches on credentialing packets, double-checking for any compliance issues, and optimizing their workloads.

It’s not easy to hire new team members into a credentialing function, so making work easier for the team you already have is a good strategy for retaining those staff.

Automation Can Help Alleviate the Provider Shortage

While automation cannot magically produce more providers, it can do some things to improve provider experience, speed up onboarding, and take burden off the providers plate on an ongoing basis.

For example, automated credentialing can bring the following benefits to providers:

  • A single intake for provider information to kick off the credentialing process, close to eliminating the time needed from the provider to complete this process
  • A faster onboarding, getting the provider seeing patients and earning sooner, whether that's getting credentialed to see patients at a provider organization, or getting into network with a payer organization faster
  • When monitoring is automated there’s no need for the provider to provide sources again when it's time to recredential

Your CVO Should be Using Automation

Healthcare organizations have long dealt with credentialing workloads by outsourcing some or all of the burden to a Credentials Verification Organization (CVO). Does it get the job done? Yes. Is it efficient, secure, or cost-effective? Sometimes not.

Whether or not your chosen CVO is efficient, reliable, and cost-effective is dependent on a number of factors:

  • Are they manually performing PSVs or using automation?
  • Are they offshoring to workers in other countries or hiring workers within the US?
  • How are they delivering data back to you? API or flat file?

These are all factors that will affect the speed, reliability, and cost-effectiveness of a CVO. For example, a CVO that offshores may have lower rates, but could have issues with data leaks and slow turnaround times. Whereas a CVO that uses automation can improve their turnaround times and keep rates reasonable because of operational efficiency.

When a CVO uses automation to perform PSVs and create credentialing packets they can move at a much faster pace. Here at Verifiable our CVO team consistently averages 250 completed packets per month, per team member! That’s because we use our automated credentialing software to complete CVO services

Better yet, our CVO team enjoys using the software, often citing that credentialing with automation is a much more pleasant way of doing things compared to manual processes.

Your In-House Credentialing Team Benefits the Most from Automation

As previously mentioned, it’s not the easiest task to expand a credentialing team. The work is repetitive, but the pressure to get things right is huge. This combination makes for a stressful role when teams are relying on manual processes to perform credentialing.

When you enable your in-house credentialing team with automation, they can trust that PSVs are being done to high standards, and can focus on outlying situations, provider growth, audit preparation, provider experience, and more. It’s unnecessary to make them perform these repetitive tasks that make the job tedious, and the turnaround times slow.

When you increase the capacity of your existing credentialing team you may even be able to discontinue your partnership with a CVO and bring the function entirely in-house. This gives you the highest level of control and efficiency.

Jump over here to learn more about the benefits of insourcing your credentialing in our guide on the topic.

Want to learn more about how you can harness automation to improve efficiency and reliability in your credentialing? Book a demo today.

More articles