Healthcare organizations across the country are striving to create efficiencies and cut costs. Many are taking the leap to outsource credentialing to a Credentials Verification Organization (CVO) or making the transition to create their own Internal CVO. The benefits of centralizing are enticing as they include increased revenue, decreased costs, and improved provider satisfaction. However, it’s important to understand that not all CVO’s are created equal and your experience or return on investment will differ depending on which you choose. There are 4 key fundamentals that a CVO must have to be successful.
Your medical staff must have access to real-time information when needed. If there’s an issue with a provider or question regarding an expiring item, the CVO must have the ability to respond quickly. A CVO that’s web-based with the ability for clients to login and see attempts, notes, completed services/items, along with documents is a must-have. Of course, if you can find a CVO that can integrate with or work in your web-based credentialing and privileging platform - even better!
Whenever I ask an MSP (Medical Staff Professional) why they don't utilize a CVO, they generally respond that they haven't found one as thorough as they are. MSP’s take their role very seriously, as they should, and understand they’re ultimately responsible for any credentialing mistakes found. Ensuring the CVO has an effective quality assurance program with the necessary E&O Insurance is important to protect all parties involved.
Healthcare organizations often need to onboard a new provider without much notice, so being able to submit a “Rush Request” and knowing it will still be completed correctly is imperative. Generally speaking, we see timeliness improved when you’re integrated with a CVO; calling, mailing, faxing and emailing requests to the CVO and vice-versa is a huge waste of time that could be spent actually verifying credentials.
Regardless of how good a CVO is at being transparent, detailed, and timely - it won’t matter if they have poor customer service. The CVO should feel as if it’s an extension of your medical staff office, treating your employees with courtesy and respect. Additionally, CVO’s are typically in direct contact with your providers and set the tone for what they can expect from your organization.
Deciding whether to create a CVO or outsource credentialing to an external CVO is a significant decision and should be considered carefully. Good due diligence in selecting a CVO partner will save you time, money, and a huge headache if you later determine they aren’t a good fit. Don’t hesitate to assess their performance periodically to ensure they continue to meet your expectations; you may even want to vet some of their employees and/or processes. At the same time, don’t shy away from vetting your organization’s ability to create and manage your own CVO as the benefits of either will drive down costs, increase efficiency and deliver greater provider satisfaction.