Electronic credentialing might offer benefits
September 1, 2009 4 minutes read
Electronic credentialing might offer benefits
Every manager wants to believe that the credentialing process has properly vetted all the organization's health care professionals to ensure that they are qualified and have no known criminal record. But that is not always the case. Too often, managers get a phone call alerting them that one of their staff or physicians has a problem that did not show up in the credentialing process.
The reason for some problematic employees and physicians slipping through the system often comes down to the administrative burden of doing a thorough background check, suggests Matthew Haddad, president and CEO of Medversant Technologies, a company in Los Angeles that offers credentialing and other services for providers. Although managers understand the need for researching the background of any and all employees, credentialing can be a long, expensive, and grueling process, he says.
In the time when most methods are moving from paper to digital, the credentialing process is no different, and managers might want to consider a more modern version of credentialing than the systems that have been in place for years. Along with several other companies and nonprofits, Medversant offers a software tool that ensures information on all health care providers is centralized, up-to-the-minute, and accessible to appropriate parties, therefore enhancing patient safety and the quality of care.
The old way of credentialing involves gathering a great deal of information, usually on paper, about the individual and then trying to confirm much of it yourself. Health care providers in recent years have moved more and more toward utilizing electronic databases and other computer resources, but Haddad says there still are many that could automate the process much more.
"What has traditionally been a mostly manual process turns into an electronic process that is faster, but at the same time offers better, more reliable information," he says. "Even though most hospitals have some sort of software in use, the software acts like a filing cabinet for the information, so that you still have to go find the data, print it out or copy it to another location, and use multiple sources for a report."
Electronic credentialing software, such as that offered by Medversant, actually does much of that work for the provider, rather than simply acting as a storage site for the data, Haddad says. "So, when you need to check various third-party sources to find information on an individual, the system automatically does that rather than a staff person having to go to each of those third-party resources and manually checking them," he says, "and it does that continuously. The system checks that information as often as those outside databases update, and you could never have enough staff to do that manually."
That constant updating provides a nearly real-time snapshot of the individual's information rather than relying on what might be outdated and incomplete information retrieved by hand at the beginning of the credentialing process, Haddad says.
Automating the credentialing process allows large health care organizations to move their credentials data from paper files to a more useful type of information, says Anthony D. Begando, founder and CEO of Tenon Consulting Solutions, a health care consulting company based in Alpharetta, GA, that has used electronic credentialing on behalf of its health care clients. "Automated credentialing provides organizations with a detailed inventory of the clinical skills across their enterprise," he says. "Automated credentialing substantially reduces the administrative burden placed on providers and greatly improves compliance."
In addition to services such as those offered by Haddad's company, Begando recommends the Universal Provider Datasource (UPD) offered by CAQH, a Washington, DC, nonprofit alliance of health plans and trade associations. (Editor's note: For more information on the UPD, go to www.caqh.org/ucd.php.) The UPD allows managers to leverage existing provider credentials information and electronically monitor hundreds of sources of sanctions data for providers.
Begando says moving to an automated credentialing environment allows for centralization of credentialing activities across an entire enterprise while preserving local privileging and board review processes. By participating in an electronic credentialing system such as the UPD, providers benefit from an improved credentialing process that yields more reliable information, and they also encourage a more cooperative relationship among providers, he says. For example, his system prompts for a new license before the current license expires, he says.
Haddad says some malpractice insurers have indicated that they might offer discounts for using electronic credentialing. "They're talking about offering discounts in the range of 8% to 10%," he says. "They see benefits in terms of the provider being better able to screen out potential sources of liability down the road, so they see it as cost-effective to offer the discount to their customers who use a service like this."
Sources
For more information on electronic credentialing, contact:
- Anthony D. Begando, Founder and CEO, Tenon Consulting Solutions, Alpharetta, GA. Phone: (678) 990-0417. Web: www.tenonconsulting.com.
- Matthew Haddad, President and CEO, Medervsant Technologies, Los Angeles. Phone: (213) 291-6139. Web: www.medversant.com.
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