Provider Credentialing

Biggest Meets Best

For three decades, Verisys has served some of the largest and most complex healthcare organizations in the United States, credentialing more than two million events annually. Our provider credentialing services get – and keep – you compliant.

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.

Using a credentials verification organization (CVO) like Verisys to assist with the provider credentialing process assures nothing and no one slips through the cracks.

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.

VERISYS: MAKING PROVIDER CREDENTIALING A SNAP FOR THREE DECADES

Aggregating provider data since 1992

Millions records in our provider and sanctions database

Primary sources

Taxonomy types in all 56 U.S. states and jurisdictions

Million credentialing events to date

Million credentialing events annually

New records added monthly to our provider exclusions and sanctions database

Direct and indirect clients

CheckMedic is a SaaS platform that streamlines end-to-end provider credentialing, monitoring, and data management.
VerisysConnect offers an efficient and highly accurate means to perform data inquires and primary source verification for provider credentialing and compliance through its self-serve engine.
Enrollment accelerates and simplifies the application, verification, and attestation process for network providers.
Data Services improves data accuracy, timeliness, and quality by eliminating inaccurate and incomplete provider data.
Provider Directory meets compliance and consumer demands for easy-to-use online, mobile, and printed formats.
Verified License Search and Status, VLSS, assures that the licenses, registrations, and certifications held by a provider are current, in good standing, and in line with credentialing, privileging, and enrollment requirements.
ProviderCheck gives an instant pass/fail status on the five critical data points of a prescriber’s status. Dispense and file claims with certainty.
Network Management strengthens your provider relationship management with a custom Salesforce app.

Easy Solutions

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.

COMMITTEE SERVICES

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.

DELEGATION SERVICES

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.

ALLIANCE 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.