Consider a healthcare organization that has done everything “right.” They’ve created efficient workflows, employed a stellar team to oversee operations, and even secured the latest technologies to boost productivity. However, when it comes time for a provider to join the organization and deliver patient care, they find that this provider’s credentials aren’t current.
The delay in onboarding costs the organization weeks and thousands of dollars—taking a toll on both their operations and the patients relying on the new hire to help address their medical needs. CVO credentialing can help avoid scenarios like this by establishing a centralized process for verifying and managing provider credentials, allowing healthcare organizations to breathe easy knowing that they’re prepared for any new hire, regardless of how complex their background may be.
This guide will discuss the ins and outs of provider credentialing including its importance within provider credentialing, how it can help organizations improve operations, and how Azulity’s innovative solution can help you achieve your goals.
Azulity’s provider credentialing services allow healthcare organizations with innovative data management to optimize operations and reduce the risk of costly delays and errors.
What is CVO Credentialing
CVO credentialing refers to using a credentials verification organization to perform medical credentialing on behalf of a healthcare practice or organization. The CVO is tasked with obtaining primary source verification of a provider’s documents on the organization’s behalf.
Verifying the credentials of medical professionals is critical for patient safety. The credentialing process confirms that any provider interacting with a patient is reliable and trustworthy and has completed the required education and certifications.
A CVO verifies a provider’s qualifications to administer care or services for a healthcare organization during medical credentialing. Credentials are documented evidence of the provider’s license, education, training, experience, or other qualifications that confirm their status. The CVO obtains verification of these details from the primary source (for instance, educational institutions and former employers) and maintains the information file. Insurance companies may not reimburse healthcare organizations for a provider’s services without proper medical credentialing.
A healthcare organization must have complete trust in its Credentials Verification Organization (CVO), as so much is at risk. The CVO should be well established and have a long track record of performing medical credentialing on behalf of many organizations. The accuracy and timeliness of the submitted information are essential. Additionally, the CVO should have strict security measures in place to protect its sensitive digital data on the providers it credentials.
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Importance of CVO Credentialing in Healthcare
Boosting Healthcare Performance and Outcomes: How Credentialing Verification Organizations (CVOs) Improve Care Quality
Credentialing Verification Organizations (CVOs) meticulously evaluate and verify healthcare providers to confirm they meet stringent performance standards. This process ultimately creates networks of highly qualified clinicians, improving patient care. CVOs conduct comprehensive background checks, reviewing education, licensing, certifications, and malpractice insurance. This verification aligns with the regulatory standards of federal and state medical bodies.
CVOs offer high-quality assurance by ensuring only the most qualified doctors are in-network. By weeding out unqualified providers, CVOs enhance healthcare outcomes, preventing subpar experiences and elevating overall healthcare quality.
Cutting Healthcare Operating Costs with CVOs
Credentialing Verification Organizations (CVOs) are pivotal in enhancing operations by identifying and mitigating fraud, waste, and abuse.
Advanced Tools for Fraud Detection
CVOs deploy sophisticated tools and analytics to detect licensing violations, improper claims, and other types of fraud. Their comprehensive data analysis uncovers hidden patterns and potential fraud.
Streamlining Workflows
In an era of financial and workforce challenges in healthcare, CVOs play a crucial role in accelerating verification and enrollment processes, enhancing the efficiency and effectiveness of healthcare delivery.
CVOs are essential in the healthcare sector because they improve the accuracy of provider credentialing and verification, leading to reduced fraud, controlled costs, and better care for members.
Azulity: Who We Are and What We Do
Azulity specializes in healthcare master data management and provider credentialing services, bringing proven expertise in implementing healthcare data solutions and credentialing across the US. Our comprehensive platform ensures consistent patient, provider, location, and claims data synchronization across all systems and departments.
Key features include healthcare MDM, provider MDM, reference data management, credentialing, and provider enrollment. We serve healthcare technology leaders – from CIOs and CDOs to VPs of data platforms and credentialing – helping them eliminate the costly problems of fragmented data systems. Book a call to learn more about our healthcare master data management services today!
7 Best CVO Credentialing Services For Healthcare
1. Azulity: The Ultimate Solution for Provider Credentialing
Azulity focuses on healthcare master data management and provider credentialing services. The company has extensive experience implementing healthcare data solutions and credentialing across the United States. Their comprehensive platform ensures consistent patient, provider, location, and claims data synchronization across all systems and departments.
Key features include healthcare master data management, provider MDM, reference data management, credentialing, and provider enrollment. Azulity serves healthcare technology leaders—from CIOs and CDOs to VPs of data platforms and credentialing—helping eliminate the costly problems of fragmented data systems.
2. NCQA: CVO Certification for Better Operations
The NCQA Credentials Verification Organization Certification helps improve verification operations and protect consumers by ensuring a consistent, effective, and diligent verification process. This CVO certification focuses on consumer protection and customer service improvement. It provides a framework for organizations to implement industry best practices that help them efficiently verify practitioner credentials. The standards help credential verification organizations identify improvement gaps and align their services with those desired by potential contracting organizations.
3. Verifiable: Get Providers Credentialed Fast
Verifiable’s CVO team has the expertise and the potential of the Verifiable credentialing automation platform to deliver the fastest turnarounds with unmatched reliability. Turn your compliance bottleneck into a competitive advantage with credentialing software and services that streamline your operations and enable you to optimize your provider network.
4. Andros: Trusted CVO Services Powered by Exclusive Technology
Andros eliminates antiquated processes and drastically reduces the manual labor and operating costs typically necessary for healthcare provider credentialing. Their platform offers the strictest level of NCQA certification available. With rigorous standards applied to every file, Andros drastically reduces errors and audit risks — so you can be reassured that your network quality is exceptional.
Combining speed with NCQA certification ensures that credentialing meets the needs of health plans, providers, and patients. Through data intelligence and automation, Andros credentialing removes manual work, significantly reduces admin times, and creates efficiency never before found with CVO credentialing processes. As a result, Andros can give you an ROI of 300% or more on CVO services compared to fully staffed internal teams using in-house data systems and traditional manual workflows.
5. CureMD: Simplifying Payer Enrollment Services
Don’t let credentialing bottlenecks hold you back. Let CureMD simplify the payer enrollment services — their physician and healthcare provider credentialing services save you weeks of repetitive work, allowing your team to focus more on patient care. With their centralized process and experts, you can accelerate revenue, save time, and reduce stress.
6. Symplr: Fast, Accurate Credentialing and Provider Enrollment Services
Symplr CVO helps reduce administrative burden and get providers in front of patients faster. We’ll handle your credentialing, provider enrollment, and licensure applications while ensuring full compliance. Symplr CVO provides flexibility to address your backlog and scale your credentialing and enrollment processing potential. You can delegate your entire provider credentialing and enrollment workstreams or just a portion. Their experts work alongside you to support your team with complete, unmatched visibility into our processes.
7. Medallion: Simple, Reliable Results for Your Business
Medallion’s CVO makes it simple to get consistent, reliable results that comply with regulatory frameworks and give you high-quality verified data to help your business scale. Confidently establish delegated agreements with guidance, expertise, and support from Medallion’s experts. Generate provider rosters and sync them with health plans without manual effort — saving you time and effort.
Step-by-Step Efficient CVO Credentialing in Healthcare
1. Use Azulity: Your CVO Credentialing Partner
The first step in setting up a CVO credentialing program is to choose a credentialing verification organization (CVO). Azulity specializes in healthcare master data management and provider credentialing services, bringing proven expertise in implementing healthcare data solutions and credentialing across the US. Our comprehensive platform ensures consistent patient, provider, location, and claims data synchronization across all systems and departments.
Key features include healthcare MDM, provider MDM, reference data management, credentialing, and provider enrollment. We serve healthcare technology leaders, from CIOs and CDOs to VPs of data platforms, and we provide credentialing to help them eliminate the costly problems of fragmented data systems. Book a call to learn more about our healthcare master data management services today!
2. Let Your CVO Know What You Need
Once you select a CVO, notify them of your need for primary source verification, credentialing, licensure application, provider/payer enrollment assistance, or any other unique need for credentialing support.
3. Schedule a Call to Discuss Your Current Credentialing Challenges
Next, schedule a meeting to discuss your organization’s unique needs and your current challenges.
4. Request a Customized Proposal to Meet Your Needs
After the initial call, ask for a customized proposal based on your needs, budget, staff, and the credentialing technology used at your organization.
5. Identify Credentialing Performance Metrics
Ask what credentialing performance metrics—or key performance indicators (KPIs)—will be used to show the return on investment. Develop one set of performance measures and reporting processes that will be used.
6. Measure Data Points Throughout the Credentialing Lifecycle
Finally, measure multiple data points along the lifecycle of enrollment and credentialing to pinpoint problems or delays. Share the same provider data management software resource with your CVO if possible.
Related Reading
- Credentialing and Privileging
- How Much Does Credentialing Cost
- Types of Credentialing in Healthcare
- Hospital Credentialing Requirements
- Provider Enrollment and Credentialing
- Primary Source Verification Credentialing
Book a Call to Learn More About Our Provider Credentialing Services
A CVO, or Credentialing Verification Organization, is an organization that verifies the credentials of healthcare providers on behalf of other healthcare organizations. The CVO gathers information from various sources, including primary sources like medical boards and other organizations, to verify a provider’s education, training, and experience.
This information is essential for initial and ongoing credentialing and privileging processes within healthcare organizations. CVOs help streamline the credentialing process, which can take months to complete. Outsourcing this function to a CVO can minimize patient care delays and improve operational efficiency.
Why Are CVOs Important?
Credentialing verification organizations play a crucial role in the healthcare industry. They help ensure healthcare organizations have the most accurate and up-to-date information about their providers. This is especially important from a patient safety perspective, as research indicates that nearly 30% of medical malpractice cases involve a lack of proper credentialing and privileging processes.
Moreover, the Joint Commission and the National Committee for Quality Assurance require organizations to verify provider credentials regularly. Failing to do so can negatively impact patient care and organizational accreditation. CVOs also help healthcare organizations reduce costs and improve efficiency.
Organizations can alleviate the administrative burden on their staff by outsourcing the credentialing verification process to a CVO. This helps streamline operations and minimize patient care delays. Further, CVOs utilize technology and up-to-date databases to ensure accurate and timely verifications.
Azulity: Who We Are and What We Do
Azulity specializes in healthcare master data management and provider credentialing services, bringing proven expertise in implementing healthcare data solutions and credentialing across the US. Our comprehensive platform ensures consistent patient, provider, location, and claims data synchronization across all systems and departments.
Key features include healthcare MDM, provider MDM, reference data management, credentialing, and provider enrollment. We serve healthcare technology leaders – from CIOs and CDOs to VPs of data platforms and credentialing – helping them eliminate the costly problems of fragmented data systems. Book a call to learn more about our healthcare master data management services today!