General Credentialing   /   March 2015

3 Steps to Credentialing Success (& How to Avoid Common Mistakes)

3 Steps to Credentialing Success (& How to Avoid Common Mistakes)

In our last post, we outlined what health-tech startups need to know about credentialing and WHY it is uber important to get an effective credentialing process in place, early.  Now let’s talk HOW.

  • Provider application: The application is the first step in the credentialing process. You’re essentially requesting information from your providers about themselves and their practice history. It’s important to cover basic information about the provider, professional credentials, professional experience, and where they practice. Then ensure they answer a series of attestation questions that speak to their professional conduct.
  • Verifications: Once you receive the application from the provider, it’s your job to verify the provided information. The correct way to verify the information is by validating the provider’s self-reported information against the originating or primary source (a.k.a. Primary Source Verification or PSV). For example, if you’re validating a provider’s medical license, the Primary Source for that piece of data is the state’s medical board or department of health. The chart below contains key elements of the provider’s application that you’ll want to verify along with the primary source:CredentialingChecklistDepending on the level of credentialing you’re aiming to complete you may also want to include:CredentialingChecklist2
  • Review/Approve: Once all of the information above is compiled, your medical director or medical officer should review and determine if the provider meets your organization’s quality standards and then communicate the decision back to the provider.

Many organizations are prone to make a few mistakes through this process. And one of the worst mistakes you can make is to annoy your clinical staff and damage the relationship between your administrative team and your providers.

Here’s how you can avoid ticking off your doctors:

  • Don’t treat your doctors like they’re guilty until proven innocent. Credentialing is a process not an inquisition
  • Don’t ask for the same information over and over again. Plan your forms ahead of time and collect the information you need once
  • Don’t make doctors fill out different forms for every department
  • Do have a data repository that allows everyone in your provider-facing organization to access the provider data
  • Do make it easy for providers to keep their data up to date

If your health-tech startup is starting to implement a credentialing process and you are interested in learning how the CredSimple platform can help you facilitate good working relationships with your doctors, contact us!

Source: New feed

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