6 Steps to Protect your Organizations

Credentialing Software, CredentialingMost organizations today have adopted “Best Practices” when vetting new hires, regardless of position or contract status. Industries like healthcare, transportation and education have taken it to the next level by requiring it as well as creating guidelines to follow. With auditors to examine compliance and enforce requirements, it’s no longer enough just to ensure requirements are followed - you must have a paper-trail that can prove it! During the “verification of credentials” process, the best practice is to have the following information, for each verification, regardless of the type of industry/standard your organization adheres to.

Who Obtained the Results?

Require a method to document the name and title of the employee who actually verified the information. For example, if someone called to verify a college degree, the name and title of the person who made the call should be documented. Even if the employee leaves the company, their name and title should remain with the record.

When was the Verification Obtained?

An auditor isn’t interested in how many attempts were made or when those attempts took place, they want to see the date and time the result/verification was actually obtained. If a fax was received, the date and time it was received should suffice. The date is extremely important especially for items that aren’t static - like sanctions.

How was the Verification Obtained?

These days there are several methods to obtain a verification of credentials - fax, phone, website, mail, etc. These are all acceptable in most cases; however, some industry auditors require an actual copy of the verification. In these cases, a phone call to verify information should be followed by an email or fax so there is documentation to support the conversation.

Source of Verification

Due to the many ways one can obtain verifications, it’s equally important to document who provided you with the information. Depending on the method, the source may vary. For example, it could be the url of the website you searched or the name and title of the person you spoke with. Regardless, the source should be clearly documented.

Discrepancies and Gaps

Another important step in verifying credentials is documenting discrepancies between what the provider/applicant provided and what can actually be verified. Some industries require the applicant certify and/or attest that information provided is accurate. In some cases, discrepancies found may be enough to prevent an applicant from being hired. Identifying gaps in employment/education can be a red flag that the applicant hiding information from you!

Document Copies

Many industry standards require a copy of the verification be attached to the file. This is not only important for meeting standards, but can be a "C.Y.A." in the event of an issue or dispute. Your ability to show auditors or attorneys the actual copy of the results you received is paramount to reducing your organizations exposure to potential litigation or a settlement. To ensure none of the required steps are missed, it’s important to arm those performing verifications with the appropriate technology. In healthcare, credentialing software that not only requires the necessary documentation, but stores it in a way that meets your organization’s requirements is imperative. After all, what good is doing all the right things, in all of the right ways, if you can't prove it!

Provider Credentialing


Jim Leonard

About the Author
Jim Leonard

Jim serves symplr as the business development leader of Provider Management and Payor Enrollment. He brings more than 20 years of highly successful sales, marketing and consulting leadership to symplr. His team’s focus is to aid clients with the identification and resolution of gaps in current credentialing, privileging, peer review, quality, and event reporting programs. Jim’s insight into utilizing technology to create transparency and improve operational efficiency promotes overall improvement in provider and hospital performance; further aiding clients in meeting or exceeding compliance with governing body requirements such as CMS, JC, DNV, and CIHQ.

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