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Five things you need to know about Medical Credentialing Services today
Credentialing in medical practice seeks to maintain quality standards in the medical industry to benefit patients. This process includes contacting primary sources directly to verify the healthcare provider’s qualifications. A Credential Verification Organization (CVO) contacts the institute where the provider received their degree or did training to confirm the service provider’s credentials.
Benefits of Medical Credentialing:
This process offers quality assurance to the medical industry to the benefit of all the parties. A medical center owner becomes confident that all employees meet expected industry standards. Even insurance providers prefer insuring professionals with demonstrated sufficient competence to the medical service. Medical practitioners get privileges to accept patients from insurance companies after credentialing. This allows growing the customer base afterward.
Credentialing process benefits patient, it keeps them informed that medical practice meets accurate healthcare standards. There’s the peace of mind that a practice offers high-quality patient care. The medical credentialing process maintains confidence regarding quality in medical practice through minimizing error and keeping costs down.
Credentialing Process:
Health care providers have to wait for the completion and approval of the credentialing process before beginning to work. It satisfies the patients that the practice provides excellent care always. Outsourcing Medical Credentialing services guarantees that employees in medical practice have proper qualifications and experience for proper diagnosis and treatment of all conditions. Using non-credentialed staff puts your practice at risk of legal action and losing its institutional credentials.
Perhaps you have medical students and fellows in your practice. They don’t need credentialing since their work doesn’t go beyond training. They should be guided by a credentialed staff. It allows the students to attain experience to make them qualify for credentials and privileges. This would have not been possible since they are still training which makes them ineligible for credentialing and privileging.
Verification source:
This involves directly verifying credentials from their source. It limits the chances of fraud in the process since no document from the applicant or third party source is accepted. The CVO contacts the board of medicine to confirm any one’s medical license. There are strict rules for proper certification of medical practice and for guaranteed industry best practice.
Medical Credentialing Process Duration:
The credentialing process takes about several days to a few weeks. However, it depends on the appropriate field for the credentials, the credentialing procedure, accurate filling of the application, and availability of all proper documents. It is recommended to consider credentialing about 90 days before work is expected to begin.
This gives enough time for case verification entities where request takes time to get a response as well or for the CVO to clarify discrepancies. Credentialing involves verification, evaluation, review, and approval process. The CVO has limited control over the response period from external sources to verify the information. Therefore, delays might happen when the CVO has to resubmit verification requests.
Speed up the Process:
To speed up the credentialing process, it requires the correct filling of the application. It also requires the thorough provision of all supporting documents. Another idea is to contact the verification source and request for verification in the shortest possible time. Any pending licenses might cause serious delay to the whole process. It is important to have all appropriate licenses approved before applying for credentials and privileges.