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The Benefits of Delegated Credentialing for Healthcare Providers

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For the longest time, credentialing was a major issue for healthcare providers. However, with new modern software and outsourcing providers, the process has become a breeze. Companies can now delegate and simplify a complex procedure that has been causing them headaches for decades.

In this article, we’ll explain this procedure, why it’s important for healthcare institutions, and what kind of benefits you can gain through delegation.

What is delegated credentialing?

Through delegated credentialing, healthcare institutions can easily onboard new medical professionals. Not only that, they can also improve all associated tasks, reduce human errors, and ensure their patients get the best healthcare money can provide.

In its nature, delegated credentialing is an external outsourcing process. Medical brands hire outside businesses to perform this task as a way of simplifying their day-to-day operations. Among others, by hiring an external provider, clinics and hospitals can eliminate costs associated with in-house onboarding and credentialing teams.

Most of these service companies have well-designed procedures that would ensure swift onboarding. They also rely on advanced software to streamline and simplify tasks.

4 Delegated credentialing benefits

Credentialing providers are classified as CVOs or Credential Verification Organizations. They work with various medical professionals, such as public and private clinics, hospitals, and even NGOs. When hired, they help businesses improve their onboarding process while removing the complexity of traditional credentialing.

The reason why clinics hire CVOs in the first place is because they want to reduce micromanagement. Furthermore, the modern credentialing process is heavily reliant on advanced procedures and complex software. So, instead of having to learn new programs, clinics simply delegate the activity to service providers who have expertise in this field.

While delegated credentialing might seem expensive, it’s generally cheaper than hiring an internal team. On top of that, as previously mentioned, you get much better results, much faster. Here are the 4 main reasons why a medical facility should invest in this kind of service:

1.     Saves resources

Obviously, the main reason why a healthcare provider would delegate credentialing is to save money and time. This process is extremely arduous and complex, and you need to do it in perpetuity. Although many clinics create their own credentialing teams, it’s usually much cheaper to pay external providers. 

Aside from cutting down your salaries, delegated credentialing provides another major financial perk. By performing onboarding faster, you don’t have to pay practitioners who are, effectively, not doing their job. This, in itself, will save you a few paychecks for each new doctor. While this might not sound as much, it can become a major money saver for hospitals with large employee turnovers.

2.     More control

While you might think that hiring an external provider will affect your control over credentialing, the practice has shown otherwise. With these service providers, you have much more leeway when presenting information to payors. 

As CVOs use advanced systems for tracking medical professionals’ data, they don’t make many errors, which are otherwise common for traditional credentialing. Payors and other institutions will get medical professionals’ information much sooner, and there won’t be as much data duplication and other inconsistencies.

3.     Credentialing streamlining

The secret behind delegated credentialing lies in software. Most CVOs invest heavily in the latest software and have specialized workflows for each type of medical practice. While these software costs might have a major impact on regular hospitals, CVOs don’t feel them as much as they use the same tools for all clients.

Through streamlining and process simplification, service providers can eliminate common errors. They can reduce the burden of credentialing, something that every hospital and clinic in the U.S. is struggling with.

4.     Improves overall satisfaction

It’s worth noting that credentialing doesn’t only work for clinics and hospitals; it improves the process for everyone involved. By quickly onboarding medical practitioners, your patients can also enjoy faster and better medical care. The process is also simpler for regulatory institutions as they don’t have to go back and forth with their administrative departments.

As mentioned, these benefits are crucial for larger hospitals, but they can also be beneficial in fields that lack professionals. For example, if your town doesn’t have many dentists, delegated credentialing will ensure that experts who come to the area start providing help faster.

What does the process entail?

During the credentialing process, the CVO is responsible for tackling various tasks, ensuring that the medical professional is allowed to give healthcare services. They rely on massive databases to check doctors’ credentials, education, and other certificates. Among others, they pay special attention to potential penalties that would prevent them from working.

As mentioned, a major benefit of delegated credentialing is its swiftness and accuracy. CVOs are also in direct contact with all the regulatory bodies, ensuring the process goes as smoothly as possible. Here’s how all of that would look like in practice:

  • In most cases, doctors sign a contract with a healthcare provider before credentialing can start. This puts hospitals and clinics in a tricky spot as they need to wait several months for credentialing to end. During that time, they’re legally obliged to cover for paychecks
  • Most job applications start with practitioners filling out specific forms. These job applications can range from 10 to 100 pages
  • As with any job, applicants are obliged to submit all documents, most notably degrees, certificates, and letters of recommendation. The process also includes DEA ID number, malpractice insurance carrier, and anything else that might be of significance to recruiters
  • At this point, CVOs come into play. Their main job is to confirm the authenticity of all these documents against official healthcare data sources. The healthcare provider will take into account the CVO’s feedback, deciding whether or not to interview an applicant
  • The hiring process can be really long, sometimes lasting for more than a month. This is especially true when it comes to more responsible positions
  • CVO also provides re-credentialing, periodically updating practitioners’ statuses and ensuring they can continue doing their practice in the forthcoming period

While all of this might seem a bit too much, it is a process that ensures the highest quality of healthcare.