Maintaining High Quality Credentialing Amid The Great Resignation

As a result of COVID-19, and the strain the pandemic has put on healthcare providers, unprecedented numbers of clinicians are leaving their practices–or healthcare altogether.

For health plans, this high level of turnover could have significant consequences for the size and quality of their provider network–as well as their ability to maintain an accurate provider directory.

The Ultimate Guide to Building a Seamless Provider Credentialing Process

Manual and time-consuming processes, human data entry errors, incomplete files, fluctuations in workload, costly data acquisition fees, and provider abrasion are a few reasons why health plans are exploring opportunities to improve their credentialing process.  
If you’re like most health plans, chances are you are somewhere between making a few tweaks or rebuilding your process.  Wherever you may be on the credentialing process spectrum, you need a guide to establish a baseline and chart your progression. 

Making the Business Case For Credentialing Automation

Explore opportunities to integrate health plan functions with CAQH Solutions to enable cost savings, increase quality and accuracy, and speed provider on-boarding. 

Join representatives from, BlueCross BlueShield of Tennessee (BCBSTN), and CareFirst BlueCross BlueShield for a discussion of their health plan experiences automating enrollment and primary source verification (PSV) automation:

A Tale of Three Credentialing Departments – How Health Plans are Achieving Their Primary Source Verification Objectives Despite Limited Automation

The hub of an efficient primary source verification (PSV) process is automation.  However, for many health plans, mechanizing data extraction, evaluation, and categorization may be delayed due to competing departmental priorities, cost, and limited IT resources.

VeriFide FAQs for Providers and Practice Managers

Why was VeriFide developed? 

Both health plans and healthcare providers have expressed concern about the inefficient, repetitive process associated with the verification of provider data during credentialing and re-credentialing/

In order to reduce these inefficiencies, CAQH worked with our member health plans to develop a new solution designed to more accurately, completely and easily verify provider data. Our goal is to reduce the burden for plans and providers inherent in the current process.