Hospitals and Health Systems

Data + SAAS

Simplify the credentialing and provider data management process and reduce the time from onboarding to revenue.

PROVIDER DATA MANAGEMENT MADE EASY

Verisys’ comprehensive data + SaaS solutions enable hospitals and health systems to streamline and automate exclusion screening, credentialing, and continuous monitoring of providers, staff, and entities. Adopting this turnkey, scalable approach reduces administrative redundancy and ensures compliance to quality standards and industry regulations.

  • Enrollment accelerates and simplifies the application, verification, and attestation process for network providers.
  • Screening and monitoring against FACIS, the gold standard for exclusions, debarments, sanctions, and disciplinary actions fosters an environment of qualified providers
  • Identity verification and record matching with 99.9% accuracy reduces disputes on false matches and enhances provider satisfaction
  • Automated credentials collection and verification for expedited onboarding paves a faster path to reimbursement for quality care
  • Primary source verification of licensure for all practice types across every jurisdiction in the U.S. with VLSS exposes serial license impairments
  • End-to-end individual and entity credentialing, continuous monitoring, and automated alerts with CheckMedic removes administrative burden
  • Entity search, verification, and monitoring for procurement, supply chain, and vendor management assures you remain compliant

There’s a lot under the Verisys hood

High standards:

Verisys is the only Credentials Verification Organization (CVO) that is National Committee for Quality Assurance (NCQA) certified for 11 out of 11 verification services, is Utilization Review Accreditation Commission (URAC) accredited, and is ISO 9001:2015 (quality management), ISO 27001:2013 (information security), and AICPA SOC 2 (customer data security) certified.

Data platform:

Verisys’ comprehensive data platform contains more than 320 million aggregated records derived from thousands of primary sources — and growing. Data collection began in 1992 with its Fraud Abuse Control Information System (FACIS). Verisys stores cumulative records that provide a unique, longitudinal view of exclusions, debarments, sanctions, and disciplinary actions.

Data matching science:

Verisys developed a proprietary matching logic using algorithms in combination with oversight by data analysts to collect, transform, and match each piece of data to the right provider/entity consistently with 99.9% accuracy. We stand behind our results 100% of the time.

Technology:

Our innovative technology stack transforms millions of records into intuitive, interoperable formats. This powerful solution simplifies workflow for turnkey compliance and a better bottom line.

Software:

Verisys designed and built the first data-powered Software as a Service (SaaS) credentialing platform, CheckMedic 20 years ago. Solutions innovation continued with real-time search and transaction engines, VerisysConnect, and ProviderCheck that instantly deliver accurate provider data when you need it. These unique, comprehensive solutions streamline provider data management, credentialing, privileging, and enrollment.

From the Verisys Blog

What is CVO Credentialing?

What is CVO Credentialing?

CVO credentialing refers to the use of a Credentials Verification Organization to perform medical credentialing on behalf of a healthcare practice or organization. The CVO verifies a provider’s credentials by obtaining primary source verification of a provider's qualifications on the organization’s behalf. Upon verification, a provider may then enroll in payers' health plans so that the healthcare organization can be reimbursed for services. Credentialing healthcare providers can include verification of their license, education, medical training, work...

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What Is a PTAN Number?

What Is a PTAN Number?

Because Medicare’s expansive system can be susceptible to fraud, it’s critical to identify and authenticate providers. Using a combination of PTAN and NPI numbers in their respective places helps healthcare organizations stay in compliance and protect Medicare from fraud and abuse as these organizations, providers, and patients rely on Medicare participation for their healthcare needs. To help you understand PTAN numbers, we’ve provided a guide to what a PTAN number means, how providers can locate their numbers, and how a PTAN number can be...

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Top Exclusion Reasons

Top Exclusion Reasons

Under section 1128 of the Social Security Act, the Office of Inspector General (OIG) has the authority to exclude certain individuals from federal healthcare programs like Medicare and Medicaid. In addition to not receiving reimbursement for services from Medicare and Medicaid, organizations that hire an individual from the List of Excluded Individuals/Entities (LEIE) – the list of excluded individuals maintained by OIG – may be subject to civil monetary penalties. Checking this list regularly is not only a federal requirement, it’s a best practice to...

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What to Watch Out for When Conducting License Verifications and Credentialing

What to Watch Out for When Conducting License Verifications and Credentialing

When conducting provider license verifications and credentialing, it can be easy to miss signals that something may be amiss with a practitioner’s application. Sometimes red flags that should alert an organization to potential problems are obvious, but other times they are more subtle. In either case, it’s important for healthcare organizations to be vigilant and take appropriate action if these red flags appear. Otherwise, you could be risking the safety of your patients and the reputation of your organization. Once you know what to look for, it...

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