Healthcare Credentialing is More than a Badge: 5 Reasons Your Business Should Lean into Managed Services

To comply with state and federal laws such as OSHA and HIPAA, most health organizations have adopted procedures to vet and validate the legitimacy of any vendors with whom they are doing business. They may also require background checks and health records of the vendor's employees. This is especially relevant for any representatives who may need to enter a facility or have access to electronically protected health information (ePHI) information.

In the past, credentialing requirements were primarily expected for healthcare industry representatives (HCIR); however, the COVID-19 pandemic and the industry trend toward cloud transformation have influenced the need to set credentialing requirements for all types of product/service providers and their representatives. Contractors are an example of one service provider that should be credentialed but were rarely held to this standard in the past. However, many healthcare organizations have recently initiated this requirement to meet safety requirements for patients and staff, and we anticipate the practice will expand.

5-Reasons to Lean into Managed Services

Maintaining all the required credentialing documentation for multiple states and facilities can be time-consuming and cumbersome for businesses and their representatives. Many businesses have found it more cost-effective and timely to contract with organizations that are subject matter experts in this realm. If you are still on the fence with this shift, below are 5 reasons to reconsider and lean into the option:

1) COVID-19 Safety Standards Are the New Normal –Since the staff at healthcare facilities engage daily with individuals with compromised immune systems, there is clear justification for individuals entering their facilities to provide their vaccination statuses and general health information via credentialing. As the eradication of COVID is not remotely feasible in the immediate future, these requirements are not expected to change anytime soon— or maybe ever.¹ 

2) One Size Does Not Fit All – Currently, there is not a national standard for credentialing. Policies and procedures for required background checks and medical documentation can vary from state to state and location to location—even within the same health system. In addition, different health facilities utilize varying credentialing software, which can exacerbate this issue further by making it more complex and labor-intensive to coordinate.

3) Adoption by Non-Acute Facilities – Before the COVID pandemic, most credentialing requirements were only mandatory at acute facilities such as hospitals. However, with the shift to utilizing ambulatory surgery centers and the impact the virus has levied on senior citizens residing in long-term care facilities, credentialing has and will continue to become more prevalent in non-acute care environments. This expansion will drive additional administrative requirements.

4) Optimize Your Employees' Time – The adage "time is money" is highly relevant in the arena of contemporary healthcare. For instance, one survey estimated that an average business professional spends up to 2 hours per month reviewing criteria for facilities they wish to visit and registering their information in advance of the visit.² Do these activities truly constitute the best use of an onsite team member's time? Find out what you can save by working with trained professionals who can manage the credentialing intricacies and the flux in policies.

5) Respect the Regulations and Requirements of the Customer – As mentioned, there are both legal and industry standards that health systems must follow to avoid being penalized for non-compliance. Strong relationships are built on trust, and your customers trust you with their facilities, their staff, sensitive data and proximity to patients. Making sure you are adequately credentialed instills confidence and further serves your business relationship.

In-House vs Managed Services:

The ability to leverage staff trained in the complexity of credentialing and capable of expediting and coordinating administrative requirements across credentialing systems provides both value and compliance improvement. For example, companies that used GHX's Credentialing Managed Service achieved up to a 50% increase in representative credentialing compliance over those who manage the process in-house.

Managed services for credentialing are not just for large organizations. Many mid-size organizations find greater success by keeping their sales team in the field and letting the experts coordinate the badging requirements. Whether you have 25 or 2500 representatives to be managed, we've seen exponential increases in representative compliance when a managed service is engaged.

If you would like to evaluate this service, please schedule a 30-minute appointment so that we may walk you through the potential cost savings using our value calculator.

When it comes to working with experts, there is truly nothing to lose.

¹When Will COVID Pandemic End – McKinsey and Company

² Orbees Survey 2020, Supplier Credentialing