Credentialing, the process of obtaining, verifying, and assessing the qualifications of a practitioner to provide care or services in or for your health care organization, is key to patient safety and the continual improvement of care. It’s also a requirement for reimbursement from payers like Medicare, Medicaid, and private insurance companies.
Many healthcare organizations chose to manage credentialing in-house. This is a complex process that requires many steps including conducting background checks, contacting licensing boards, reviewing license applications, obtaining education information, interviewing references, and more. It’s time consuming, and research indicates that many health professionals are unable to start working at their new facility for anywhere between a few weeks to six months, due to credentialing timeframes.
As today’s hospitals and health systems continue to face shrinking budgets, pressure to speed up the revenue cycle, and credentialing demands that far exceed their in-house capacity, many are outsourcing the function to an outside credentials verification organization, or CVO. Outsourcing your credentialing can yield many benefits. If you are considering doing so, here are five things to keep in mind.
When an organization is acquired, there’s a great amount of work to be done to ensure that the transition goes smoothly; like welcoming new patients, onboarding new employees, managing benefits, dealing with office space, etc. By outsourcing your credentialing, you’re taking one extensive task off your plate which will allow you to ensure the newly combined organization is running smoothly and nothing falls through the cracks.
Credentialing not only requires accuracy; it also demands speed. If you’re able to outsource your credentialing, you’re putting that work into the hands of a team that is focused solely on credentialing, without any distractions. Where it may take an in-house credentialing manager weeks to manually sort through the files, spreadsheets and databases involved in credentialing, a CVO will have established, highly-automated process for managing the work. This guarantees a faster turnaround time, and when turnaround times improve – everyone wins.
Organizations are becoming more and more concerned with sustainability, and one way to help with that is by going paperless. Chances are, if you’re taking care of credentialing on-premise, you’re likely working with a mix of software and paper. While this may work for you now, it’s not a long-term strategy. A CVO will use one centralized system to take care of all your credentialing needs, which will reduce paper waste and make locating specific documentation easier. Say goodbye to mile-long filing cabinets, and hello to organized documentation in one secure location!
Most of us feel like we don’t have enough hours in a day to get all our work done, and that probably goes double for those of us working in a hospital or health system. With so many different tasks to complete in a day, the intensive work of credentialing can sometimes fall through the cracks which can have a devastating impact on your organization. By outsourcing that huge responsibility, you assure it is done right and you afford yourself the time to focus on other tasks that require your attention.
Studies indicate that up to a 70% reduction in costs can occur when credentialing work is outsourced to a CVO. Many of these costs are related to freeing up your resources to spend time on patient care rather than credentialing paperwork and follow-up tasks. If you’re a larger organization with many resources dedicated to credentialing, you will also find value in freeing up office space and the associated overhead costs when you outsource credentialing.
Now that you’ve seen our top 5 reasons for outsourcing your credentialing, do you believe it’s the right strategy for you? VerityStream’s NCQA-Certified CVO Services can provide credentialing services on an ongoing basis or in an overflow capacity. We manage credentialing verification for hundreds of organizations and thousands of providers, and we can help you too.