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March 8, 2019

Understanding the 5 Critical Data Gaps in Health Care Credentialing will protect your reputation, provide better outcomes and assure that your patients receive quality care.

When you have a complete picture of your data, where it comes from, what it means, and where you might be exposed to risk, you are better equipped to make decisions that build a solid foundation for your health care credentialing process and the continuous monitoring of your entire staff.

The 5 Data Gaps:

The Source Gap – Limited sources produce limited results.

Cross-State and State-to-Federal Reporting Gap – State hoppers love this gap.

The Time Lag Gap – Old data is yesterday’s news.

Continuous Monitoring Gap – The only constant is change.

Name Matching Gap – It takes science to match data to an identity. “Will the real Dr. John Smith please stand up?”

As a patient, or health care organization, we assume our doctors are competent and will provide high-quality care. How do we know that these providers are not sex offenders or elder abusers? How do we know if they have a current license in good standing? Verisys can help you identify physicians who are not in compliance, thus protecting your organization.

The medical industry is built on the assumption of trust, however,  it is a  health care organization’s job to protect their institution and patients by screening, verifying and monitoring their populations against current, historical, verified, primary source data.

Data is like a puzzle with pieces in many different locations. Some data is national, some resides on a state level and some local, or tied to an institution, rather than a government entity. Data comes from law enforcement, from licensing boards and from Federal and State Attorney General’s offices.

For 25+ years Verisys has gathered, verified and continues to aggregate health care data into the Fraud Abuse Control Information System (FACIS®). This database currently contains eight million records matched to six million providers and updates in real time, as well as giving a longitudinal view with data going back to the late 1980’s. 

Verisys’ SaaS platform, CheckMedic., brings these millions of puzzle pieces together, verifying that the data is properly matched with the correct name. Individuals and entities being screened, verified and monitored are issued a MedPass, a digital profile within CheckMedic. The MedPass contains all relevant data on the individual and/or entity and is current, verified and actionable. CheckMedic streamlines your health care credentialing and verification processes keeping your organization compliant without adding undue administrative burden. 

The secure data platform provides access to a national abuse registry, a practitioner license data set, Verified License Search and Status, (VLSS) of all jurisdictions and taxonomies, plus results from more than 5,000 primary source publishers of civil, criminal and health care information.

Understanding the 5 Critical Data Gaps, how each Gap puts you at risk, and the simple bridge to each gap is covered in the e-book, “Closing the 5 Critical Gaps: A Guide to Understanding the Issues and Using Data Technology to Improve Provider Transparency to Protect Patients and Reduce Risk” is available to download here

Verisys is an NCQA Certified and URAC Accredited Credentials Verification Organization, and handles data reports as a Consumer Reporting Agency abiding by federal law set forth in the Fair Credit Reporting Act. Verisys stores and exchanges data from a Tier 3+ secure environment, assures 99.99% identity verification accuracy 99.99% of the time, and stands by its work with full indemnification.

Verisys complies with two international quality standards, ISO 9001:2015, certified for quality of credentialing software and background screening; and, ISO 27001, certified for highest standards of information security and data protection.

Contact us for a demo of FACIS®, and discuss a staged rollout of screening, verifying and monitoring your entire workforce through CheckMedic® and theMedPass®.


Juliette Willard Written by Susen Sawatzki Healthcare Industry Expert Muse. Writer. Publisher. Producer. Creator of Inspiring Narratives. Connect with Susen on LinkedIn