Advances in technology can significantly improve the efficiency and quality of the credentialing process

Changes in the healthcare industry are placing a growing list of demands on health plans, hospital and health system medical staff services and credentialing departments. In the quest to keep up with increasing regulatory and accreditation requirements driven by the Accountable Care Act (ACA), CMS, The Joint Commission and others, the time left for comprehensive credentialing activities is getting smaller and smaller. Yet, the obligation to ensure patient safety through a thorough, quality-driven credentialing investigation remains the same.

To relieve the time constraints of credentialing, hospitals, health systems and health plans are increasingly enlisting the services of credentials verification organizations (CVOs). A new technology is also growing in popularity, and from what I can see, it is a true game changer for the healthcare industry.

An insider’s perspective

There are many great things about my job as a consultant. Besides getting to work with physician leaders, medical staff, business leaders and CVOs, I also have the opportunity to expand my knowledge base of new and emerging technologies that support the collection, use, storage and security of practitioner-specific data. On occasion, I've provided subject matter expertise to ensure those technologies meet and exceed the needs of our evolving health care marketplace. One such technology is the CAREcvo module by Newport Credentialing Solutions.

CAREcvo is cloud-based credentialing management technology which helps health plans, hospitals, health systems and CVOs more easily manage credentialing requirements through enterprise-wide data management. CAREcvo also allows on-demand access to provider data. With this feature, staff and clients, regardless of their physical location, have a real-time view of where a provider is in the credentialing and primary source verification (PSV) process.

What is most unique about the platform is that it creates a truly comprehensive, seamless solution that supports both hospital-based credentialing and enrollment functions. Before developing this technology, Newport used its expertise to create a solution that excels in managing the enrollment process, complete with powerful, user-friendly reporting and advanced, intuitive business intelligence capabilities. The same proven principles learned on the provider enrollment side were extended to the credentialing and PSV processes. The ability to customize how users interact with the system is an added bonus.

What Newport has accomplished is the ability to manage the entire data horizon, using the same practitioner data to satisfy the credentialing needs as well as enrollment. With a click of a button information obtained during credentialing process can be pushed over to enrollment for their use. In doing so, practitioner data is consistent and retains a higher level of integrity; administrative redundancies, human data entry error and associated costs, are eliminated.

This technology will be a welcome break for CVO, health plan, hospital and health system credentialing departments who want to reduce time constraints associated with credentialing, yet retain the quality of the process. What new technology are you excited about?

About the author

Jodie Chant possesses nearly twenty years mid-to senior level leadership experience in medical staff services, credentialing, provider enrollment and health information technology, in multi-hospital academic acute care health systems, long term acute care hospitals, managed care and physician hospital organizations. Ms. Chant currently serves as the principal consultant of Jodie Chant Consulting, LLC, providing national consultative services to organizations, hospitals, health systems, centralized verification organizations, managed care organizations , accountable care organizations and clinically integrated networks in all aspects of medical staff administration and performance improvement.

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