Primum non nocere. It is imperative that not only physicians, but all involved in healthcare first, do no harm. While medical staff and healthcare administrators are at the heart of providing safe, quality healthcare, another group that is involved on the front-end of patient safety and healthcare quality are credentials verification organizations or CVOs.
CVOs act as a safeguard, verifying whether healthcare providers are qualified to practice based on a rigorous review of their education, training, background, and experience. However, according to the leading healthcare accreditation organization, the National Committee for Quality Assurance (NCQA), “credentialing is more than a ‘check-the-box’ regulatory duty, it’s an essential safety component of the health care system.”
The credentialing process generally involves in-depth examination of documents including CV, med school/residency/fellowship certificates, medical license, board certification, professional affiliations, DEA registration, CME records, case logs, references, malpractice records, and more. Credentialing takes time, expertise, and money and can have a significant impact on resources for healthcare organizations. Savvy administrators can alleviate this drain on resources by partnering with a NCQA-certified CVO they can trust for preverification.
NCQA Accreditation in Credentialing
NCQA is the leader in CVO accreditation. An NCQA-certified CVO has passed extensive review and has an effective credentialing process in place. A skilled CVO can streamline credentialing – efficiently verifying primary source documentation, giving healthcare administrators confidence in provider quality, serving as a resource for in-house credentialers, and ultimately, bolstering patient safety and quality of services.
According to NCQA, accreditation ensures a consistent, effective and diligent credentialing process, promotes industry best practices, upholds state regulation requirements, and protects consumers’ access to quality healthcare.
Why Partner with an NCQA-Certified CVO and NAMSS-Certified Professionals?
According to Diana Hall, CPCS, CPMSM, FMSP, Senior Director of Quality and Compliance for Medical Doctor Associates, “As patients, we trust our providers. We assume we will receive quality care, and we trust that our doctors are who they claim to be. As a certified credentials verification organization, we know that there is a patient at the end of every assignment – every healthcare professional that we verify. So we ensure that our verification quality is the best it can possibly be.”
Hall explains, “MDA has its own NCQA-certified CVO called CREDENT. Not only is CREDENT a CVO, it also has four National Association of Medical Staff Services (NAMSS) certified professionals. To put this into perspective, there are 6,200 registered hospitals in the U.S. (American Hospital Association) and only 4,300 NAMSS-certified professionals. This means there are not enough certified professionals to cover every hospital in the U.S. At CREDENT and MDA, we don’t need certified professionals to work here and run our risk management and compliance programs, we want them. This ensures we offer the highest quality in credentialing and staffing services.”
Hall points out one more bonus of partnering with a NCQA-certified CVO that employs NAMSS-certified professionals: “We have a wonderful resource for our clients – a whole team of qualified individuals who will speak their language and ensure they are not alone with their credentialing questions.”
Certified credentialing professionals and organizations share the same passion for patient safety and quality care as medical providers and healthcare administrators. In that vein, Hall says that CVOs and credentialing professionals can be considered among “the gatekeepers of patient safety.”