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Mitigate risk and elevate your quality of care. Improving both clinical and business outcomes starts with a smarter, more integrated approach to regulatory training, continuing education and quality management.

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Increased Regulations Drive the Need for Standardized Data and Automation

March 17, 2023
March 17, 2023

The complexities around credentialing, privileging, and provider enrollment are increasing every day. Over the past year, the surge in emergency patients associated with COVID19 and the skyrocketing demand for telehealth services, have made it abundantly clear that rapidly onboarding, credentialing, privileging, and enrolling providers in payer plans is more critical than ever. Accelerating this process is no easy feat given the fact that every payer and regulatory agency has its own unique set of requirements.

In the past, it was possible to manage credentialing, privileging, and provider enrollment data with limited resources and with separate systems and processes. Today, payers and regulatory agencies expect healthcare organizations to go further – driving a greater demand for data integrity.

increased regulations graphic  

According to the American Hospital Association,“Health systems, hospitals and PAC providers must comply with 629 discrete regulatory requirements across nine domains.”

increased regulations table
Tracking and researching regulatory requirements across various bodies and negotiating contracts with individual payers can eat up a lot of time. Inaccuracies can lead to costly compliance issues. The good news is that:

  1. VerityStream does this research for you and delivers the most up to date standardized data and content on an ongoing basis via our CredentialStream solution.
  2. We’ve designed multiple methods (depending on your state) to get you started on standardizing and migrating your data.

Standardizing Your Data

Standardizing your data collection of the following information can save countless hours and dollars for your organization:

  1. Proof of Identity
  2. Education and Training
  3. Military Service
  4. Professional Licensure
  5. DEA Registration and State DPS and CDS Certifications
  6. Board Certification
  7. Affiliation and Work History
  8. Criminal Background Disclosure
  9. Sanctions Disclosure
  10. Health Status
  11. National Practitioner Data Bank (NPDB)
  12. Malpractice Insurance
  13. Professional & Peer References

This can certainly be a daunting task. The process involves making sure that each data type has consistent content and a similar format. If there is inconsistency across your data fields for each provider, that data will not be easily reportable or useful. And it definitely won’t make automating your entire provider lifecycle possible.

  • CredentialStream’s vSource shared data tables are validated, integrated, and continuously updated including facilities, schools, payers, license boards, and health status including the COVID-19 vaccine. These data tables have been built around regulatory requirements.
  • VerityStream offers multiple solutions for standardizing and migrating your data to CredentialStream that fit your unique state, whether you have millions of lines of data, or a practice of 25 providers. Learn more about data migration options here.

Making Your Data Work for You

CredentialStream’s VerityStream Validated Providers (VVP) offers pre-populated, validated provider data that reduces the overhead required for repetitive research tasks and expedites turnaround times. With VVP, a single provider record can now be used to support all credentialing, privileging and enrollment operations, removing the need for multiple spreadsheets and checklists. This not only improves data integrity, but also speeds up your processes. And, more streamlined workflow management promotes compliance through the generation of reminders related to requirements from the growing number of regulatory agencies overseeing your performance.


Bottomline

Migrating to CredentialStream offers a path to transforming your credentialing, privileging, and enrollment operations with standardized, pre-validated data to accelerate onboarding times, improve the provider experience, and meet the demands imposed by ever-changing healthcare regulations.

Contact your VerityStream Sales Representative to learn more about our data standardization and migration paths.

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