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Credentialing as Telehealth Is Playing a Prominent Role in Our New COVID-19 Reality

Another major shift in care delivery has been the rapid rise in existing telehealth operations and deployment of new or expanded ones. Already seen as an efficient, cost-effective way to enhance care in rural areas, telehealth can now close the physical gap between providers and patients who may be nearby but cannot leave home. This also is an area where a more rapid licensure and credentialing process can be beneficial.

The National Emergency Declaration Involves Good News for Telehealth

And once again, the National Emergency declaration provides some good news:

  • HIPAA guidelines around telehealth have been relaxed for this national emergency. HHS has announced that it will exercise “enforcement discretion” and will not impose penalties for noncompliance with regulatory requirements during the “good faith provision of telehealth” services during the COVID-19 national emergency
  • Telehealth regulations around billing for Medicare services to Medicare patients have been waived under Section 1135 of the Social Security Act, and the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 provided for $500 million in telehealth reimbursements.

“Telehealth is skyrocketing because we’ve got to keep our healthcare workers safe,” says Vicki Searcy, Vice President, Consulting Services, at VerityStream. “If a person can be treated via the use of technology, that’s going to be a plus. In some organizations where there are insufficient intensivists you can provide some of those services remotely.”

The challenge will be not just to stand up a telehealth service, but also explore how changed and relaxed rules affect service delivery — and who can provide services, another element of a changed credentialing and licensure landscape.

Expedited Credentialing for Telehealth

“Credentialing managers know they need to expedite approvals, but what are the state regulations as far as licensing requirements are concerned? People are still going to need to do a good bit of research to see what they can and can’t do,” she says. “At VerityStream we’re working with providers to see how to use our automation capabilities for checking licenses, checking for sanctions, and creating workflows as it relates to telehealth. We’re helping them set up an operation that is going to be the most efficient but still meet all of the regulatory requirements. We’re working to help people understand why they don’t need to fully credential all of the telehealth providers, but how they can take advantage of credentialing by proxy and what they need to actually have in their credentialing system.”

This blog post is the second in a series of excerpts from the VerityStream article, “An Upside Down World: Pandemic Creates Process Challenges and Opportunities for Licensure and Credentialing.” The article also covers:

  • Provider Support has a can-do spirit
  • Keeping processes effective, but uncomplicated, will be essential
  • Today’s adaptations and new procedures are likely tomorrow’s business as usual
  • Patient outcomes should drive “in the moment” decision-making

PLEASE NOTE: The information in the article excerpted here was considered current at the time of its publishing. However, the COVID-19 pandemic is an ever-evolving disaster due to new findings, data, and availability of resources. Please refer to the CDC website for the latest detailed information when you need it.

In the midst of continual healthcare change some things stay the same, like the need for comprehensive provider credentialing, privileging, and enrollment processes. In today’s value-based environment, operational efficiency is critical. Conducting manual verifications, completing paper forms by hand or taking time to deliver files to various locations across the hospital or the system is not cost-effective. Learn more about making VerityStream your comprehensive provider solutions partner.


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