Healthcare Credentialing News & Insights

Credentialing How Tos January 2017

CredSimple’s Streamlined Implementation: Less Work for You AND Your IT Team

Credentialing How Tos January 2017

CredSimple’s Streamlined Implementation: Less Work for You AND Your IT Team

Implementation

Implementation of new technology can seem like a burden, which is why we’ve been purposeful with how we’ve built CredSimple. Our goal is to unburden the credentialing process and to make implementation and use of our platform as efficient as possible.

There are 2 distinct but interrelated ways our clients can use our platform: As a CVO and/or as a provider data management solution. Both uses are easy to implement within a respectable timeframe. Here’s a breakdown of what implementation actually looks like for our clients.

Using CredSimple as a CVO:

What it requires of your IT team:

  • Our CVO services utilize a cloud-based, secure website, so your IT team doesn’t need to be involved in any software setup or configuration. They’ll just need to spend 20 minutes exporting your historical credentialing data en masse.

What it requires of your credentialing team:

  • Training takes a just few hours because we’ve built our interface to be intuitive and easy to use. And your dedicated CredSimple customer success rep is always here to help.
  • From the beginning, we will work together to set you up for success: We work with you to first clean up, then import your existing data. Our database structures your data in a way that keeps it accurate and also usable. For example, addresses are only stored once in the organization’s profile. If it changes, it only needs to be updated once for it to be reflected in the “locations” section of a provider’s profile.
  • We can also train your provider relations team to log in and view the status of any individual provider or of your network as a whole (so your credentialing team no longer has to provide updates).

What it requires from your providers (if anything):

  • If you decide to use our digital application, no training is required (but we do provide support should they have any questions). It takes 20 minutes for a new provider to complete.
  • If you have complete CAQH applications, we can pull in the data without any work from the provider
  • We can import your raw data, requiring only 9 elements:
  • Full name
  • Provider type
  • NPI
  • Gender
  • State license number (& issuing state)
  • Date of birth
  • SSN or school name & graduation year
  • 1 address (to perform NPDB query)
  • Previous credential date

 

 

 

Using CredSimple as your provider data management solution:

Provider Data Management

We partner with you to clean up, normalize and organize your data, as well as to create a simple script that allows you to pipe your now-useful data back to your billing system and provider directory. Implementation takes 6 to 8 weeks.

Week 1 – 3: Data clean-up and organization. You’re the expert on your network. We are the data experts. We partner with you to clean up your data and make it useful to you, your providers and members. During the cleanup process, we standardize records (eliminating duplicate addresses) and create relationships between data that reflect real-life relationships so that this new, clean data will be easy to maintain.

Sample Client Data Clean-up Results:

  • Located and matched an additional 20,000 state license records
  • Located and matched an additional 17% of DEA licenses
  • Backfilled and corrected 23,307 missing or invalid credential types
  • Found and corrected 10% of provider addresses so that addresses are now valid USPS addresses
  • Removed 12,000 practice records after cleaning up and standardizing 66,000 records

Week 3 – 6: Script creation and testing. Our engineers work with your IT team to create and test simple scripts to map your data back to your claims system and online directory.

Let us know if you have any questions about our provider data management solution or our implementation process.