How to Select the Provider Credentialing Software That’s Right for You
Provider data management vendors have been compelled to stretch beyond their original scope to meet the rapidly changing needs of their customers. The rapid evolution in the reimbursement and regulatory environment has driven the increasing demand from hospitals and other healthcare organizations for more innovative provider credentialing software solutions.
In the past, with only a few established vendors to choose from, the provider credentialing service landscape was reasonably simple to navigate. Today, the picture is much more intricate. Hospital CIOs look for data management solutions that not only ensure proper credentialing but also help increase process efficiency and minimize potential revenue loss caused by improper credentialing. Choosing between the various data management tools is much more difficult, as many of them include value-added services and functions that were previously not part of the package.
So what should you look for when selecting a provider credentialing software? Here are our top tips to help you find one that’s right for you:
Look For These Baseline Features
Cloud-based technology has gained popularity in recent years for three primary reasons:
- It makes data sharing easy within your team.
- Thanks to digital storage capacity and backups it offers increased security.
- It is highly cost-effective, as it increases productivity, reduces maintenance and hardware costs.
Web-based systems are incredibly convenient and easy to use. Unlike traditional software that must be installed and maintained manually, cloud-based physician credentialing databases can be accessed securely from anywhere, anytime. Also, updates can be done quickly and remotely.
2. Ability to manage documents
When choosing a credentialing software, make sure it has document management capabilities. Solutions that include a function to store credential verification documents and other forms electronically will prove to be huge time-savers, allowing team members to reference them quickly and easily when needed.
3. License monitoring and process automation
Provider credentialing can take an immense amount of time and attention to detail. Be sure to choose a platform that has the built-in capacity to automate the process of verifying provider licenses. A function that searches the relevant websites that you would need to locate to find all the necessary information can be a complete game-changer. Look for a system that returns results directly in your credentialing tool after performing the search.
Commonly Used Features And Functionality
When looking for a data management platform for your organization, it is essential to be clear on your specific needs and to identify a solution that includes those features and functionalities that are likely to meet your requirements.
It comes as no surprise that according to a 2018 report published by Porter Research, the top business function used by providers is credentialing. While 92% of the respondents rely on their data management software primarily for provider credentialing, they use it for other purposes as well, such as license management (80%), privileging (71%), affiliation letters (65%), application management (64%) and peer reviews (59%). Other valuable features to look for are the ability to connect with the National Practitioner Database (NPDB) from within the platform.
Determine what is truly important to you and your organization before deciding which platform to go with. Ask yourself how you can enhance the existing processes and tap into your staff for a deeper understanding of existing unmet needs. By bringing everyone together and actively engaging your staff members in the decision-making process, you can expect less resistance and greater acceptance once the platform goes live. With the right software, credentialing can become a much more streamlined process in your organization.
symplr covers all the angles – from the credentialing, enrollment, and privileging of providers to tracking provider and practice quality to managing vendor and visitor activity in your facility – with advanced solutions, services, and support.
About Jan Laws
Jan Laws is a member of the Product Management team at symplr. She holds both CPMSM and CPCS certification distinctions through NAMSS. Prior to joining CACTUS/symplr, Jan served for more than 20 years in the Medical Staff Services field. Her experience includes roles in centralized verification organizations’ operations, medical staff management in both system and single hospital organizations, and provider credentialing. Jan eagerly shares her expertise through learning experiences that enhance the positive collaboration between symplr teams and our clients. In addition to her expertise in medical staff services, Jan is a licensed professional counselor who operates a successful private practice.