Healthcare Credentialing News & Insights

Credentialing How Tos December 2016

How to Get Rid of the Credentialing Black Box: Make Status Updates Easy

Credentialing How Tos December 2016

How to Get Rid of the Credentialing Black Box: Make Status Updates Easy

Why is Jessica so Frustrated?

Jessica is a busy credentialing coordinator who has been in her role for 5 years. Today, she arrives at her desk to voicemails and emails from the provider relations department requesting status updates on credentialing for their new providers. By lunchtime, she has received more status requests. Every time she gets a request, she has to stop what she’s doing, log in to the dinosaur of a database — which takes five minutes just to look alive — and then look up the provider’s status. And if an application lives in CAQH, Jessica can see that the provider hasn’t completed their application, but she has no idea if the provider has even started or whether they’re 99% done.

In the middle of fulfilling her umpteenth status request of the day, Jessica’s boss asks for a network and provider insights report. The credentialing files in her queue are going to have to wait until tomorrow. It will take the rest of the afternoon to find and format the info her boss has requested.

Jessica knows the importance of keeping  the provider relations department informed. She knows that operations and the company VPs need to know the overall network status to make strategy decisions. But every time she gets a request like this, it means putting off actually processing credentialing files. Interruptions like this keep Jessica’s department, and hundreds of other credentialing departments across the country, from doing their jobs efficiently and in a reasonable timeframe.

The problem isn’t that all these departments need information, it’s that most credentialing teams aren’t equipped with the right tools to effectively and efficiently communicate with other departments.

Provider data and credentialing statuses are siloed in legacy databases or excel spreadsheets that can only be accessed and interpreted by a few people in the credentialing department.

What’s worse, if a health plan is using a CVO, the credentialing team won’t be able to accurately provide status updates or network report. They either have to rely on the old data of the last report or wait until the next status report is sent over by the CVO in the coming months.

CredSimple Makes it Easy to Retrieve and Share Status Updates (Securely)

CredSimple was created to remove the pains of the credentialing process at every step. It doesn’t make sense that data is siloed. And unsearchable. And out of date. It doesn’t make sense that the overall credentialing process actually costs more time and money than necessary in this technology age.

With CredSimple, credentialing coordinators like Jessica don’t need to answer status updates or network and provider insights questions because those teams can have this information at their fingertips. They simply log in, search for the provider’s name and see the status in real time. They can also see exactly how far along each provider is with their application (whether they’ve started and if they are 10%, 70% or 99% of the way through). Providers also receive real-time, direct feedback on their credentialing application. If data is missing from their file, they are notified immediately — cutting down credentialing delays.

We’ve automated primary source verification (and other steps in the application-to-approval process) so we are able to credential providers in an average of 5 days, which decreases the need for frequent status updates in the first place!

CredSimple also has built-in reporting functionality. Our search and filter functions allow credentialing teams to prepare the customized reports, so it’s easy to run reports whenever management requests them. In addition, the data can be downloaded for downstream operations, and because our data is updated directly from primary sources monthly, it remains accurate.

Our platform makes it easier for everyone to do their job well.

Let’s face it. The demands on credentialing teams have changed but credentialing technology hasn’t evolved as it should — until now. Automation, efficiency, and ease are built into every aspect of CredSimple’s CVO platform. People expect to have credentialing updates in real time. At CredSimple, we think this reasonable. Learn how we can help or request a demo.