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Benefits of using a credentialing verification organization

Credentialing & Verification Update, July 18, 2007

Hospitals have a number of opportunities to involve a credentialing verification organization (CVO) in their credentialing activities. Such activities may include distributing and receiving applications, conducting primary source verification, collecting letters of reference, querying the National Practitioner Data Bank (NPDB) as an agent of the hospital, and verifying clinical experience.

Although a CVO might be more efficient because it devotes its time exclusively to primary source verification, the CVO's true benefit lies in minimizing the bureaucracy for physicians who might otherwise be required to complete a separate application for each organization at which they seek medical staff membership and/or clinical privileges.

For example, a physician who seeks privileges in three managed care organizations (MCOs), four hospitals, a nursing home, a surgicenter, and an independent practice association may currently need to complete 10 applications-one application for each entity. But if the physician goes through a CVO, he or she needs to fill out only one application, saving both the physician and anyone involved in processing his or her application valuable time.

Every hospital that uses a CVO should note that even though it might delegate a part of its credentialing to the CVO, the hospital still bears the ultimate responsibility for the entire credentialing process and its outcome. Therefore, a hospital should monitor a CVO's activities to ensure that it follows all policies and procedures. Your hospital might want to check whether the organization meets the National Committee on Quality Assurance's (NCQA's) accreditation requirements for CVOs; accreditation usually indicates a quality credentials verification system.

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