Medical credentialing is an essential part of providing top-notch healthcare services to patients. Clinics, practices, and other healthcare facilities take advantage of this process to make sure that practitioners can meet patient expectations.

While medical credentialing is a time-consuming process, it’s key to avoiding medical malpractice lawsuits, improving patient satisfaction, upholding a stellar practice reputation, and much more.

Not too many practices have sufficient time and resources to arrange effective medical credentialing without losing focus on other important activities. That’s why they choose to hire a Credentials Verification Organization (CVO).

A CVO takes care of the medical credentialing process while leaving the healthcare facility and its HR team sufficient time to focus on patient care and other revenue-generating activities.

Credential Verification Organization: Definition

A credential verification organization is a third-party service provider that handles medical credentialing for healthcare facilities. This organization takes a comprehensive approach to medical credentialing to make sure that practitioners hired by healthcare facilities and practices meet the necessary professional qualification standards.

The CVO takes care of the administrative activities that accompany each verification process. It collects, verifies, and transfers the practitioner’s information to all interested parties.

The primary source of verification for a reliable CVO is NCQA standards. Accredited organizations have to meet the following requirements:

• The organization can’t be licensed as a Health Maintenance Organization (HMO), Point of Service (POS), EPO (Exclusive Provider Organization), or Preferred Provider Organization, (PPO).
•  The organization can’t be eligible for NCQA credential as a health plan or a Managed Behavioral Healthcare Organization (MBHO)
• The organization needs to perform credentialing activities directly or according to a contractual agreement.
•   The organization needs to perform credentialing activities for a minimum of 50% of the places the practitioner works in.

While CVO gathers information about new and existing practitioners and verifies their credentials, it doesn’t provide any evaluations based on the collected documents. The healthcare facility receives all copies of the reports and makes its own decisions based on the information. The CVO can’t decide whether it’s reasonable to award a practitioner any privileges.

Benefits of Working with a CVO

Many healthcare facilities try to handle medical credentialing on their own. While it’s possible to monitor current employees and arrange credentialing for new practitioners without assistance, the process is usually complex and time-consuming.

By choosing to take advantage of CVO services, healthcare organizations can enjoy several important benefits.

Faster Credentialing

In some cases, credentialing can take around six months or even longer. This causes a significant delay in the onboarding process and keeps qualified practitioners from contributing to your healthcare organization’s success.

CVOs know exactly how to approach the credentialing process in order to minimize the waiting time.  They remain ahead of the competition by streamlining the credential process and offering clients a faster and more efficient service.

Efficiency

A medical credentialing specialist earns around $40,000 per year. That’s why many organizations delegate the credentialing process to the internal staff. While this saves money initially, it generates unexpected expenses in the long run.

When a person who has little experience with medical credentialing handles the process, they are highly likely to make mistakes. Even a small error can easily extend the credentialing process and keep the practitioner from working for your organization longer.

Mistakes made during the credentialing process could cause the organization to make the wrong decision about the practitioner. In the worst case, this could eventually lead to a malpractice lawsuit.

When you work with a CVO, you are leaving medical credentials in the hands of professionals. This minimizes errors and increases efficiency.

Employee Satisfaction

When you delegate medical credentials to the internal staff, you are overwhelming employees with extra responsibilities. This keeps them from focusing on their work and causes frustration.

With medical professionals, especially nurses, still recovering from the terrible burnout they faced during the COVID-19 pandemic, adding credentialing to their set of responsibilities could lead to low satisfaction rates.

Less Downtime

When you delay medical credentialing, a qualified practitioner can’t contribute to the success of your practice. By working with a CVO, a healthcare facility can speed up the process and reduce downtime.

Meanwhile, a CVO can monitor current practitioner credentials and arrange re-verification whenever necessary.

Some organizations worry about sharing control over credentialing with a third party. While CVO handles the credentialing process for you, it doesn’t make any decisions. It’s up to the healthcare facility to decide whether to accept the practitioner’s services.

Working with a Credentials Verification Organization

While it’s possible to arrange medical credentialing without assistance, working with a CVO can yield impressive benefits. By speeding up the credentialing process and taking the burden off your staff’s shoulders, CVO saves you time and money.

Healthcare facilities that take advantage of CVO services enjoy peace of mind about credentialing and gain access to qualified professionals faster.