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 efficiency.
This article explores the benefits and challenges of moving credentialing in-house. It discusses how this shift can offer more control, reduce costs, and improve workflows.
NCQA accreditation helps generate significant return-on-investment by streamlining credentialing efforts, shielding provider organizations from costly risks, and maintaining the trust of key stakeholders – i.e., patients, major payers, regulators, and practitioners.
Not only do following NCQA credentialing standards open pathways to securing and keeping the trust of payers (as well as federal and state regulators), they’re also best practices that reflect positively on the health systems and practitioners that apply them.
Primary Source Verification (PSV) is the process of verifying a provider’s qualifications and competencies by reaching out to and obtaining information from the issuing authority or original source of that information.
Developing a provider network strategy in today’s market has never been more complicated. Siloed data, multiple information streams, and unknown credentialing statuses leave organizations open to not just compliance issues, but also a loss in providers and members.
What should operations leaders and credentialing professionals know about insourcing their processes in today’s market? Can the promise of speed and cost savings from automation carry over into credentialing, while still meeting regulatory requirements, and enhancing provider experience?
Increasingly, healthcare systems and payers are saying “yes” to delegated credentialing to save time, and money, and even reduce liability. Delegated credentialing leverages the expertise of other entities (internal or external) to handle this arduous process.