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Healthcare Credentialing

Credentialing, as the name suggests, has to do with credentials. Healthcare credentialing refers to verification of the qualification of a healthcare worker or service provider. The process entails confirming the legitimacy of any licenses, academic papers, and qualifications of an employee.

Credentialing process is essential in ensuring patients get quality medical services. It also helps insurance companies in the settlement of bills. Maven Concept reaches out to the source of each employee document to verify the authenticity. This process is known as primary source verification (PSV).

After years of working in healthcare facilities, we offer guidance for credentialing for healthcare practices to do it themselves. We fully understand all the requirements. Apart from that, we know the certifying bodies, legit training facilities, and relevant regulatory bodies.

Healthcare Credentialing Process

Before any practice, any health worker should go through credentialing to confirm their eligibility. Patients should be guaranteed their safety through qualified medical staff. A health facility should have a credentialing officer.

However, for most healthcare startups, credentialing might be difficult because of the limited resources. But because it is a necessary practice for all employees, you can contract Maven Concept to help you with the process. The steps we take include:

1. Basic qualification screening. We do a background check to determine whether the person in question has the necessary educational background and mental capacity to work in your facility.
2. Deny or accept the application to proceed to the next stage.
3. Submission of the necessary educational qualifications, licenses, and permits. Depending on the position, these requirements may differ.

4. Primary source verification (PSV). This involves calling the official issuers of the documents to confirm the authenticity.
5. Onboarding training before practice. Even after verifying the necessary papers, the healthcare workers need the training to familiarize with the systems and process in your organization.
6. Shadowed practice. The new employee should perform tasks under the supervision of an experienced co-worker to assess the execution.

Maven Concept ensures that the healthcare medical credentialing process learns smoothly and gives the staff an easy time adapting. As professionals, we offer advice on areas of improvement and training if need be.

Contact us for Services

Are you starting? Do you have a running health facility that needs a CVO guidance? Get in touch with Maven Concept.

Maven Concept Credentialing Services

We focus on 3 categories of credentialing services:

1. Provider enrolment

Health facilities should get verification from insurance providers and any affiliated hospitals before any engagement. We ensure that you have met all requirements from both local and federal authorities. This gives your facility a large pool of payers to work with and offers your patients flexibility.

Hospitals that want an affiliation with your facility also need credentialing. Hospital credentialing comes in handy to ensure compliance with all legal and medical requirements. The affiliates also make sure you meet the requirements.

2. Start-up or Initial Credentialing

When starting, you should ensure your facility meets all the requirements, and so does your employees. The process involves a lot of verifications and confirmation of education certificate legitimacy. We also go through work experience documents to verify the level of skills. Some of the licenses and certificates require a single application, although others are annual or after a certain time.

3. Recredentialing

To ensure you are up to date with the trends in the industry, we do regular check-ups. Unlike initial credentialing, this process is not as rigorous because we don’t have to do it again after verifying some documents—for example, academic certificates and work experience.