LOS ANGELES – Provider credentialing – a constant, tedious and expensive task for hospitals and other entities in the healthcare system – is getting renewed attention.
Technology providers are positioning applications and services as a way for healthcare organizations to perform needed verifications to ascertain that practitioners have the necessary licenses and accreditations and that their professional backgrounds are untarnished. In addition to helping facilities grant admitting privileges, credentialing also helps them limit their malpractice risks.
Until recently, healthcare organizations had checked providers’ credentials every two or three years. However, with new requirements from the Joint Commission on Accreditation of Healthcare Organizations, the standard now is to check credentials as often as possible, said Matt Haddad, CEO of Medversant, a Los Angeles-based credentialing service.
“What complicates this for most organizations is that a managed care organization might have tens of thousands of practitioners to check, have multiple data sources to check and have to check providers in a continuous process,” Haddad said. “It becomes geometrically harder to handle.”
Medversant recently introduced OneSource, a Web-based, shared-platform service. It can be used by a variety of healthcare organizations on a per-use basis similar to an application service provider format, but with additional services available.
OneSource uses automated queries to continually check the latest information on providers’ credentials, and it’s designed to be a one-stop shop for credentialing information.
Medversant isn’t alone as a credential service company. Medkinetics, recently formed in Franklin, Tenn., is offering similar services. Its applications were recently recognized by Dell Computer, which named MedKinetics the 2007 winner of the Dell/NFIB Small Business Excellence Award.
Technology solutions will increasingly facilitate the credentialing process and reduce the cost, said Karen Greenrose, president and CEO of the American Association of Preferred Provider Organizations, which recently published a white paper on technology-based provider credentialing.
Because many physicians contract with multiple healthcare organizations, the credentialing process is duplicative and time-consuming, costing $40 to $100 per physician.
“With greater use of the technological resources now available, PPOs can create a more efficient credentialing process, reducing the time and cost burden on providers and payers,” Greenrose said.