Privilege Providers and Credential Facilities easily with CredentialStream

CredentialStream

The health care system is going through a volume-to-value transformation with the goal of controlling cost and improving patient outcomes. Same Day Care providers are leading the charge by reducing barriers to care and delivering better outcomes at lower cost. Demand for Same Day Care is at an all-time high, but exponential growth has resulted in decreased payer reimbursements, stricter industry regulations, and increased competition.


If you’re an Ambulatory Surgical Center, Federally Qualified Health Center, Urgent Care Clinic, or a Retail Health Clinic, you must ensure that your patients receive competent care at qualified facilities from capable caregivers. But, privileging and credentialing providers and facilities is a time-consuming job that can easily get lost in the shuffle. The key to be sure it all gets done is: AUTOMATION.


HealthStream's industry leading automated privileging and credentialing solution, delivers a comprehensive library of delineated privileges for more than 100 adult and pediatric specialties, including physicians, advanced practice professionals, and non-physician specialties and access to a continuously monitored credentialing solution that integrates with over 1,000 primary sources such as federal exclusion, sanction, verification, Medicare/Medicaid, state exclusion, criminal background sites and more to ensure your patients receive competent care from qualified people.


But, providers aren’t alone in needing to be credentialed. Health plans also require facilities to be properly credentialed in order to provide care to their members. CredentialStream monitors health plan credentialing requirements, allowing you to stay on top of the facility credentialing process and ensuring your ability to provide care while eliminating inefficiencies and expediting reimbursement.

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Distinct Care Settings = Distinct Needs

Same Day Care Distinct Care Settings = Disctinct Needs

With CredentialStream you can:


  • Develop and maintain evidence-based privileging criteria
  • Clearly define the delineation of clinical privileges
  • Validate, identify and match data via a proprietary algorithm
  • Eliminate facility credentialing inefficiencies and expedite payer reimbursement 

Get CredentialStream, and get a single system – built around the best content, data, and practices – to manage all your privileging and credentialing needs.

How can we help you today?

Ambulatory Surgical Centers


CredentialStream for Ambulatory Surgical Centers


Federally Qualified Health Centers


CredentialStream for Federally Qualified Health Center


Retail Health Clinics


CredentialStream for Retail Health Clinics


Urgent Care Clinics


CredentialStream for Urgent Care Clinics


CredentialStream Enables Same Day Care Providers To:

Protect Patients and Ensure the Delivery of Quality Care Through Proven Privileging and Credentialing Processes

Same Day Care settings provide easy access to on-demand, affordable care and meet the healthcare needs of a variety of patient populations. But, to provide care in these settings, health plans require that facilities be credentialed and your providers be privileged. CredentialStream allows you to easily manage your facilities credentialing while processing privilege requests, delinations and approvals in the Urgent Care, FQHC and Ambulatory Surgical Center settings and the ability to quickly credential providers in Retail Health Clinics to eliminate inefficiencies and expedite reimbursement.

Go Paperless

Only a little more than half of the enrollment professionals we surveyed use some type of software solution to help automate their processes. A process rooted in paper leads to clerical errors and data loss. CredentialStream moves credentialing, privileging, and enrollment online – creating a single source of truth and eliminating the need for manual processes and file storage.

Maintain Facility Compliance While Reducing Payer Enrollment Processing Times

Ensure your facilities’ credentialing status while expediting payments with CredentialStream. Manage, accelerate, and automate the process of requesting facility and provider participation in health insurance networks with thousands of pre-formatted forms that populate in seconds, including forms from CAQH, PECOS, Medicaid and more.

Reduce Aging Receivables and Claim Denials

Estimates indicate that 80 percent of all credentialing applications submitted are lacking information required for the payer to process the application properly. CredentialStream automates your credentialing process so you can avoid clerical errors and oversights that halt payer reimbursement and affect a provider’s ability to practice and collect reimbursements from payers.

Create a Culture of Compliance

Navigating the complex regulatory healthcare environment can be difficult and regulation oversight can negatively impact the health of your Same Day Care practice. With CredentialStream you can electronically verify and monitor performance according to standards set by: CMS, State Departments of Public Health, TJC, IMQ, and more.