HealthcareHow CVO Services Enhance Healthcare Provider Verification?

Credentialing is one of the most arduous and annoying procedures for healthcare providers. As you probably know, medical institutions in the US are forced to renew their credentials every two to three years. The process is also performed each time you onboard a new physician.

The biggest issue with credentialing is that it can take so much. This can affect healthcare organizations’ ability to collect money from payers. Even worse, it would prevent new physicians from performing their duty for several months.

To remedy the issue, clinics, and hospitals often turn to CVO organizations for credentialing. That way, the medical staff can focus on the thing they do best: saving people’s lives!

What are credential verification organizations?

Credential verification organizations, or simply CVOs, are entities that perform external, delegated credentialing of medical staff. Nowadays, it’s very common for healthcare providers to hire these organizations in an attempt to reduce their administrative work. Furthermore, this practice is allowed and regulated by the Joint Commission.

CVOs represent their clients in credentialing procedures, gathering data on practitioners who have been with the clinic for a while or those just onboarded. Credentialing is vital for all parties, allowing healthcare organizations to do their business uninterrupted while relieving patients’ worries regarding practitioners’ expertise.

Credentialing is state and federal-enforced and regulated activity. During the verification process, a credentialing provider does its best to obtain relevant education information, work history, relevant training data, licenses, and certification. The procedure is extremely meticulous and might include abuse and sex offender registry checks.

Keep in mind that credentialing is an ongoing process. Verified practitioners are always under scrutiny, with CVOs constantly updating their personal information. A provider pays close attention to any sanctions they might’ve suffered, such as debarments and exclusions.

To further streamline the process, the Joint Commission offers monitoring guidelines that include peer and chart reviews and patient communication.

CVO certification process

Similar to their clients, CVOs can be certified. Although this isn’t a mandatory procedure, it can provide numerous benefits to a provider.

Like in many other industries and professions, a CVO certificate doesn’t come easy. Every provider has to undergo a strict evaluation that ascertains their proficiency. Most notably, the certification helps establish that an organization is adhering to industry standards.

Among others, regulatory agencies are trying to determine whether a CVO is committed to patient safety. They do so by analyzing data and monitoring credential verification organization’s work. During the evaluation process, the regulatory body will put emphasis on CVO’s internal procedure and organizational structure.

The verification process includes various methods such as questionnaires, client references, surveys, error rate reviews, and regular audits.

Who needs credentialing?

Truth be told, the majority of healthcare organizations and practitioners require some sort of credentialing. Sometimes, it’s hard to keep track of requirements for different specialists, which is another reason why healthcare providers hire external providers. For example, just the nursing position comes with 9 credentialing options.

As expected, medical education is the biggest ticket on the list. The provider will regularly check if a practitioner has finished college or specialization or obtained some other certificates. Credentialing can include the following positions:

• Medical doctors and physicians
• Doctors of osteopathic medicine
• Dentists and dental hygienists
• Registered nurses
• Physical and speech therapists
• Occupational therapists
• Phycology counselors
• Licensed family and marriage therapists
• Group medical practices
• Hospitals
• Clinics
• Home health agencies
• DME companies

It’s worth noting that the verification process is mandatory for each location that a medical company has. If a business consists of several offices throughout the city or state, each one will be assessed separately. Credentialing is also mandatory for newly onboarded medical professionals.

All medical staff is required to renew their credentialing every two to three years. Regardless, between two periods, your CVO will keep a watchful eye on any status changes that might’ve occurred.

What are the benefits of hiring a CVO?

Although hiring a CVO comes with a few inherent risks that are otherwise common for all external providers, performing delegated credentialing is still the way to go. Credentialing organizations provide numerous benefits, including:

• Verifying establishments’ and practitioners’ credentials, which puts patients and other stakeholders at ease before partnering up or doing check-ups
• During the process, CVO establishes whether a clinic or hospital is putting patients’ health and well-being first
• CVO also analyzes adherence to state and federal regulations and standards
• The verification process also tests healthcare providers’ organizational credibility. In other words, CVO assesses practitioners’ competency, training, and experience, the company’s medical equipment, and current workflows
• A verification agency is also checking whether a company is in legal trouble or has suffered any sanctions
• Among others, CVOs are in charge of improving the accuracy and timeliness of primary source verification

Generally speaking, these companies take care of all meticulous processes that a healthcare provider doesn’t have the time or resources to execute.

How to find the best CVO for your healthcare business?

First and foremost, you should be looking for organizations that are considered the industry-leaders by their peers. A good way to establish whether a CVO is reputable is by acquiring feedback from patients. It’s vital that people coming to your clinic feel comfortable being examined by practitioners verified by elite CVOs.

Track record goes a long way in determining if a company is the right fit for your healthcare organization. Focus on brands that have high data accuracy and use the newest, high-quality tracking software. Generally, good organizations will have solid, long-standing relationships with primary sources and licensing boards.

You can tell a lot about the organization based on how they’re checking historical data. The ability to analyze past performance and prior sanction tells you that a provider uses an enormous database and is meticulous when checking relevant registries.

All in all, CVOs have to fulfill 40 core standards when assessing a healthcare provider. Besides analyzing the clinic’s policies and procedures, the credentialing organization also has to put emphasis on organization structure, regulatory compliance, quality and information management, staffing, oversight, and even marketing and sales.

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