How to Choose the Right Healthcare Credentialing Software

All healthcare organisations are obligated to verify the credentials of every healthcare professional working within their organisation.

Historically, medical credentialing would be carried out using endless paper forms, spreadsheets, and emails. Manual credentialing was rarely the ideal credentialing solution, especially for larger organisations that rely heavily on resources, as this creates bottlenecks and leaves the organisation open to the risk of having uncredentialed healthcare providers delivering patient care.

But now, technology has opened the door to other solutions. More and more organisations are exploring medical credentialing software like Credentially, to help with credentialing management as well as improving the speed and accuracy of their credentialing process.

This article outlines how healthcare credentialing software works and details the types of tasks that the best software can perform.

What is medical credentialing software?

There are a limited number of credentialing software that have been designed by medical credentialing experts. Most software solutions tend to be more generic software solutions.

Those solutions that are tailored for healthcare credentialing will not only support the credentialing process, acting as credentialing management software. However, they also have the capacity to upgrade the entire credentialing infrastructure, making it more efficient, more accurate, and less resource reliant.

Credentially are pretty unique in the healthcare credentialing software market right now because our platform for designed specifically for healthcare credentialing, by experts in the healthcare industry.

This industry knowledge is vital because the right healthcare credentialing software can completely transform a credentialing department and the work-life of credentialing staff. That makes credentialing more proactive and less reactive.

Why Credentialing Is Becoming Increasingly Important

Credentialing is essential for healthcare organisations to ensure providers are properly licensed and can provide reliable healthcare.

Healthcare organisations and are recognising that they must change to be more flexible in how they deliver different services, whilst maintaining the quality of patient care. Less-urgent or resource-heavy health care services are being moved out of hospitals when they can be done as well or better in other settings. This will add an additional burden on credentialing requiring teams to quickly credential healthcare providers in a wide range of healthcare locations.

However, on the flip-side of this more flexible approach to providing healthcare, quality of healthcare and patient safety remains a primary objective, with regulations becoming more demanding.

To support healthcare providers and credentialing teams, they could partner with a credentialing service, but with the need for credentialing increasing to meet the demand for more flexibility, the cost would scale accordingly. 

How Credentialing Software improves the credentialing process

The best credentialing software allows teams to store information and credentialing processes, making them easier and more efficient. 

Specialised credentialing software can do the following:

• House large volumes of healthcare provider data in a centralised, secure location that is easily accessible
• Eliminate reliance on paper and spreadsheets
• Automatically validate credentials and assesses qualifications
• Track deadlines and renewal requirements in real-time, giving credentialing teams a live snapshot of their credentialed resources and potential future risks
• Automate credentialing tasks, such as sending reminders.
• Enable healthcare organisations to remain compliant with industry credentialing regulations and requirements
• Positively impact the time it takes to get a provider credentialed and working

How to Choose the Right Credentialing Software for Your Organisation

Before discussing the criteria you should employ to identify the right credentialing software for your healthcare facility or organisation, it is worth exploring if you have a current or near-future requirement for a credentialing platform. Here are some questions to ask as you investigate your options for credentialing software:

• Why are we considering the software - and why now?
• What ROI should you expect?
• What are the other anticipated costs?
• What is the realistic timeframe to implement the system?
• Where will the software be located? Will their need to be buy-in from the IT department and what infrastructure is required to
• What level of commitment do you have from key stakeholders, including department and organisational leaders?

Modern Features to Look for in Credentialing Software

There are a number of generic credentialing software platforms that cover some of the basic requirements. However, they are not specifically crafted to serve the needs of medical credentialing departments. 

We are going to focus on the specific attributes, found with industry-specific software, which can make a healthcare organisation’s credentialing process - and other operations - more effective and efficient.

Serious credentialing software should also do the following:

• Among the key features, explore platforms that provide a system housed in a secure cloud environment, which means your organisation’s representatives - along with providers - can securely access the system from any digital device.
• Integrate with provider credentialing information from the Council for Affordable Quality Healthcare (CAQH). CAQH is a not-for-profit alliance of health insurers that gathers and maintains a repository of provider credentialing information.
• Be able to track and monitor credentials for healthcare providers other than physicians, including nurse practitioners, physician assistants, physical therapists, and mental health providers.
• Automatically give updates and warnings on upcoming expirations of certificates or other renewable credentials.‍
• Track continuing medical education requirements.
• Incorporate a seamless for peer review. When required, the software solicits, incorporates, and stores feedback about the provider from current and former medical staff.‍
• Be implemented and adopted by staff in a relatively short period.
• Have an easy-to-adopt interface, with a personalised dashboard.
• Include large amounts of space to store and manage any data that an organisation wants to retain about a provider.
• Allow for the use of electronic forms and e-signatures.
• Generate customised reports.
• Automate reminders to healthcare providers.
• Manage medical billing - if appropriate.
• Act as a supportive of re-credentialing as with initial enrollment.
• Integrate with word processing software for the easy creation of letters and documents.
• Integrate with email software for easy communication through the system.
• Provides exceptional customer support.

How many of these processes above does your current compliance software provide you? Food for thought.

Takeaways

Credentialing is an essential but time-consuming process that healthcare organisations and facilities have to invest in to meet their regulatory obligations. Manual credentialing, which most organisations have utilised at present, is resource-heavy and has the potential to cause bottlenecks leading to fulfillment issues. 

With patient care, the primary focus, the ability to quickly and efficiently verify the credentials of staff is important, but equally important is the department's capacity to remain compliant while constantly re-credentialing existing medical staff. Too often, lapses occur.

Most software platforms offer some of the features you would want from your credentialing platform, but they suffer from being a general solution for multiple industries. A better solution is to engage with a specialised medical credentialing software provider, which has been designed with the industry in mind.

You should expect software that provides a secure cloud server to store data in one place. Software connected to DRB platforms and other data providers should be compulsory, as should automated verification processes like reminders. 

Finally, you should expect a personalised dashboard that allows you to manage your current resources and have real-time insights into the state of current credentialing to be able to forecast and plan resources. 

About Credentially

As a bespoke medical credentialing software, we work with healthcare providers and recruiters, saving them time and money by automating sign-up credentialing and compliance.

We offer our clients many of the features outlined above, as well as a number of others. But rather than focusing on features and how they benefit credentialing, one of the key components to our success to date has been the focus on customer support. 

We have clients set up, onboarded, and trained in weeks, with our team on hand to facilitate adoption. Here is what a current client recently said about us:

“My favourite thing about Credentially is how customisable it is, so you can make sure it meets our specific requirements. The customer service is absolutely brilliant - our questions always get a really quick response, and if we have any issues our account manager is always really responsive and receptive and works with the dev team to make it fit our needs.”

For a no-obligation walk-through or an informal chat, speak to our Credentially team today.