Provider Credentialing from the Largest CVO in the US
No Easy Job
Credentialing and recredentialing providers is a complex process for health plans, hospitals and health systems, and state Medicaid agencies. Here’s why:
- Physicians are licensed in multiple states and provide telehealth services across state lines. This requires license verification with each state board and compliance to that state’s unique regulations.
- Identity matching is complicated due to physicians having the same name, maiden names, alias names, nicknames, or abbreviated names.
- To get a complete view, each physician must be screened, and credentials verified against thousands of primary sources.
We screen all 868 provider types (taxonomies) in all 56 U.S. states and jurisdictions and can monitor your population to keep you in compliance, even when new legislation is passed. Individual states and federal standard-setting organizations have ever-changing regulatory requirements, but Verisys stays up to date on all changes and that means you maintain ongoing compliance and avoid fine, fees, and penalties.
Credentials Verification Services
From primary source verification to recredentialing roster services, Verisys is the largest outsourced Credentials Verification Organization (CVO) in the United States. Because we’ve partnered with some of the most complex healthcare institutions for 30 years, we can help you do anything from a simple provider credential search to implementing a full end-to-end credentialing solution.
Credentials Monitoring Services
Continuously monitor your population to maintain compliance and avoid fines, fees, and penalties. We’ll notify you of changes in license status and provide advance notice of license, registration, or certification expiration dates. Monitoring against our FACIS database also means you’ll know of any new exclusions, sanctions, or adverse actions.
We provide virtual committee services for our healthcare credentialing clients. These services include primary source verification, reviewing operations and policies, calendaring, meeting minutes, reviewing provider profiles and documentation, credentialing applications, and any file actions needed for both clean and excluded files.
As part of our delegation agreement, Verisys accepts responsibility for the CVO credentialing process, but the healthcare organization remains responsible for meeting National Committee of Quality Assurance (NCQA) standards. Verisys will review the delegation agreement, do a pre-delegation evaluation, monitor, and manage the roster as part of our CVO services.
Verisys leads the industry in managing state Medicaid credentialing programs in partnership with several state and state-wide consortiums. These alliances improve provider satisfaction while lowering credentialing costs by aligning credentialing to a single, common event, shared by participating managed care organizations.
Self-Service Credentialing Software
Simplify, streamline, and automate provider credential searches and credentialing processes with Verisys’ self-service software platform. Our proven solution provides everything you need for primary source verifications with faster turnaround times.