A Better Credentialing Process is Better Business

The Best Care Starts with Credentialing

Until now, credentialing has run on outdated systems, spreadsheets and repetitive manual work that only increases work, delays, costs and potential downstream risk due to human errors.

CredSimple transforms provider credentialing into a fast, compliant and cost-effective process for healthcare organizations who are dissatisfied with inefficiencies that lead to burned out employees, dissatisfied providers and missed business opportunities.

CredSimple built the Credential Verification Cloud (CVC) – a technology solution that automates the monotonous verification work required for compliant credentialing. And we’ve simplified everything else: the application, committee review prep, approval, ongoing monitoring, recredentialing and reporting.

Simplified Credentialing

We've simplified and sped up the process with built-in compliance and smart technology.

  1. 01. / Apply

    We’ve removed the pain from the application process for you and your providers.

    Apply- Real Time Credentialing Data Verification

    2 of our 3 application options require no work from your providers.

    • Our digital application takes 20 minutes to complete or we can import data from CAQH or import your raw provider data in bulk.
    • Our application’s real-time data validation means providers can’t input incorrect information (so won’t need to return later to correct answers).
  2. 02. / Verify

    Stop data entry and manual data verification.

    Verify - Instant Credentialing Alerts

    Faster results, fewer errors. That’s the beauty of automation.

    • We use data-matching algorithms for primary source verification.
    • Programmatic compliance: requires up-to-date attestations, work history gap explanations and answers to disclosure questions.
  3. 03. / Find

    No filing cabinets.  No black box.

    Find - Searchable Credentialing Data

    Your entire credentialing process is now digital. Welcome to the technology age.

    • Every piece of data is searchable and reportable, including specialty, language, malpractice info, credentialing status and more.
    • Each provider’s profile includes all data gathered at every step of the credentialing process, giving you the whole picture in one place.
  4. 04. / Approve

    Let our system do the admin work.

    Approve - Review Complete Credentialing Files

    Reduced work for recording decisions and scheduling follow-up tasks.

    • Highlights risks to the credentialing committee without prep time.
    • All documentation can be viewed on one screen in a consolidated report. The report is the permanent record and is compliant to standards.

Credentialing Software That Ticks all the Boxes: Fast, Accurate, Compliant & Cost-Effective

Physician credentialing is the first step to providing members and patients with the quality of care they are seeking. It’s also the first step in the value-based care equation.

We’ve built the technology that allows health plans, health systems, telehealth providers and other healthcare organizations to offload the work of direct and delegated credentialing to smart technology in order to receive compliant results on thousands of files in an average of five days.

Goodbye screen scraping, manual data entry, backlogs and overtime.

Hello efficiency, meaningful work, speed, accuracy, cost savings and job satisfaction.

Getting providers credentialed quickly affects your entire business, whether you’re gearing up for open enrollment, network adequacy, clearing a backlog (to stay compliant) or focusing on strategic goals by increasing efficiency, saving your employees time (and headaches) and your organization money.

Automated Primary Source Verification

Let’s face it. Manual data entry is tedious and the amount of paperwork your credentialing team processes every month not only wears on your team, it also creates overtime, burnout and turnover. The manual work involved in healthcare credentialing typically includes:

  • Reaching out to each primary source to verify information for each provider
  • Retyping data into your credentialing software or spreadsheet
  • Hours sorting through paper files or mining spreadsheets to prep for committee
  • Long turnaround times resulting in significant time spent responding to status requests from provider relations and management

Automated primary source verification reduces data entry errors and speeds up the overall credentialing process, saving your team a ton of time (as well as sparing them from tedious work that leads to burnout).

NCQA-Certified Provider Credentialing

Our CVO platform programmatically ensures the strictest level of NCQA compliance and offers the transparency and speed your business demands, providing your team with efficiency and peace of mind.

CredSimple received scores of 100% across all 10 NCQA certification elements for credentials verification. Hiring CredSimple not only takes the credentialing burden off your shoulders but also reduces the audit burden.  The simplest way to get 100% credit during your next NCQA audit is to delegate to an NCQA-certified CVO such as CredSimple.

Adherence to the Highest NCQA Standards Is No Easy Feat

Most healthcare organizations struggle with the provider credentialing process in one significant way or another. This can show up in a number of tangible ways. One costly example is manual work. Manual primary source verification and manual data entry lead to long turnaround times which leads to backlogs and increased resource consumption in the form of overtime, added headcount, burnout and turnover.

Health plans can also struggle with NCQA standards and requirements. There are 6 common mistakes we see healthcare organizations make as they endeavor to meet NCQA standards. Most clients struggle with at least one of these at any given time. We’ve also put together an NCQA credentialing requirements blog series to help demystify NCQA standards.

Credentialing is one of those processes we don’t want to think about because of how onerous it is but it’s important to get it right. Your medical credentialing process affects your bottom line and strategic goals. It’s up to you whether it produces a headwind or a tailwind to your business.