How to perform delegated credentialing

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Comprehensive medical credentialing is key to providing top-notch healthcare services to patients. When hiring medical personnel, healthcare facilities arrange the credentialing process to find out whether the new worker can help patients the way they claim to in the resume.

While extremely helpful, credentialing is a complex and time-consuming process. It takes some practices over six months to complete. During this time, they can’t take advantage of the provider’s services. This causes both parties to lose time and money.

To streamline and speed up the delegated credentialing process, many healthcare facilities delegate it to third parties, such as Credentials Verification Organizations (CVOs). These outsourcing partners make it easier to complete credentialing while ensuring consistent results.

Let’s take a closer look at performing delegating credentialing.

The Importance of Medical Credentialing

Excellent healthcare services are among the top-demanded services in the world. For many people, they are hard to find. Healthcare facilities, offices, and practices work hard to maintain their reputation.

According to HealthGrades, 77% of patients turn to reviews when searching for healthcare services. Maintaining a stellar reputation is key to bringing new patients to the doorstep.

To do that, you need to make sure that you are hiring the best candidates. While they can provide all the necessary information about their experience, certifications, and licenses, it’s up to the medical facility to check their validity. Medical credentialing is key to making sure that a new provider doesn’t hurt your reputation.

The other serious problem that many medical service providers face is malpractice lawsuits. More than 40% of Americans believe that they are victims of medical errors. While not all of them file lawsuits, the annual number of claims in the country is high.

By arranging medical credentialing, medical facilities reduce the chances of lawsuits by ensuring higher-quality medical services. If the provider you hire fits the standards you set, you don’t need to worry about frequent medical errors.

Overall, medical credentialing contributes to a seamless functioning of a medical facility. That’s why the majority of practices prefer to take advantage of it.

Why Delegate Medical Credentialing

At first glance, the medical credentialing process doesn’t appear complicated. That’s why many medical facilities choose to perform them on their own. In reality, the process comes with a wide variety of nuances that need extra attention. Ignoring these elements could lead to mistakes, which delay the process.

When an organization takes advantage of CVO credentialing, it outsources:

The process of collecting verifications

Managing applications and reapplications

Reporting to the client

Once the medical facility receives the report, it makes a decision on whether to start or continue working with the provider in question. This is the only task they need to handle. Accordingly, the internal staff without experience in credentialing doesn’t have to lose focus on their everyday activities.

It usually requires a dedicated full-time staff member to handle credentialing. Besides initiating the process and ensuring all the necessary steps, this employee has to monitor re-credentialing requirements. Otherwise, it’s easy to miss the re-credentialing date and put the health of your patients in danger.

The average salary of a credentialing specialist is around $45,000. Coupled with recruitment and retention costs, such a hire leads to significant expenses for the medical facility.

If the facility doesn’t have a large enough HR department that is ready to handle the entire medical credential processing, delegating medical credentials is an excellent alternative to burdening existing employees with extra tasks.

Performing Delegated Credentialing

If you decide that delegated credentialing is the right choice for your medical organization, you need to take these steps:

Find a Reliable CVO

Finding a reliable CVO is key to performing delegated credentialing for your practice. While this may seem like a complex process, there are only a few things you need to check. First, you can ask other facilities for recommendations. If none are available, you can make a list of local organizations and evaluate the following:

How They Store Information

When you share information with a CVO, you want to make sure its safe and secure. Organizations that arrange high-quality cybersecurity measures to ensure data safety are worth your consideration.

Since you aren’t just sharing the potential provider’s data but giving the CVO information about the organization, you want to make sure it stays in the right hands. With the number of cyberattacks increasing every month, it’s imperative to pay special attention to data safety.

Whether They Track Re-Application Needs

Many medical licenses have expiration dates. Even if the CVO verifies the provider credentials, they need to continue monitoring their licenses and certifications. Once these documents expire, they check whether the provider renewed them on time.

They should also track re-application needs. If you approve the provider to work for your organization for a certain period, you need the CVO to restart the verification process on time.

How Well CVO Communicates

To speed up the verification process and make sure you have all the necessary data to make the right decision, communication with the CVO should be seamless.

Before hiring a CVO, ask what communication channels they use and how often they contact their clients. You should also know whom to call if you have an urgent matter to discuss.

How Much Experience They Have

A reliable CVO should have sufficient experience working with different medical organizations. Without experience, it’s easy to make serious mistakes that could cause you to come up with a bad decision. This, in turn, can end in lawsuits.

It’s always better to choose a CVO that has experience working with healthcare organizations in your area.

Provide The Right Information

Correct, updated, and timely information is key to improving and speeding up the verification process. While it’s important for the healthcare provider to present all the necessary information and application for verification purposes, the healthcare organization should also be ready to provide data related to its policies and procedures.

It’s your responsibility to maintain contact with the verification service provider to make sure that your actions or lack thereof don’t postpone the verification process.

Sign a Delegated Credentialing Agreement

A delegated credentialing agreement is a document that states the verification-related responsibilities of both parties. In some cases, you can delegate the entire credentialing process to a CVO, in others, you can keep some of the functions in-house.

The agreement should also outline the reporting schedule and format to make sure you receive appropriate information as soon as possible to make relevant decisions.

Delegating Credentialing to a Third Party

Delegated credentialing is a time and money-saving opportunity for healthcare organizations. To make sure it yields top results, you need to find a reliable credentials verification organization and arrange a collaboration according to your organization’s needs.

By taking full advantage of delegated credentialing, you don’t just take the burden off your in-house team, you speed up the verification process, gain access to a wider network of healthcare providers, and boost patient satisfaction.

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