Internet Based Credentialing

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Internet Based Credentialing
Presented by Cheryl Tensley
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Verifications Available on Internet

• State Medical Licenses
• DEA License
• Specialty Board Certifications
• American Medical Association (AMA)
• Medicare/Medicaid Sanctions through OIG
• Current Hospital Affiliation Status

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Web Site Addresses on QEW Help Desk
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Mass Media Search
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May Yield Results!
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Internet Verification TrackingObjectives

• Technical Solution
• Performance Improvement
• Labor Efficiency
• Quick Access to Information
• Compliance with All Standards and Policies

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Actions

• Update tables to include web site addresses and
  mark electronic verification

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Update Hospital and Institution Tables
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Actions

• Update tables to include web site addresses and
  mark electronic verification

• Add a record for each type to be verified

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Add a Record to Provider Licensesfor
Verifications Needed
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Actions

• Update tables to include web site addresses and
  mark electronic verification
• Add a record for each type to be verified

• Specify a letter for each type in the
  verification set and execute the set

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Specify Letter for Each Type in Verification Set
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Actions

• Update tables to include web site addresses and
  mark electronic verification
• Add a record for each type to be verified
• Specify a letter for each type in the
  verification set and execute the set

• Use electronic verification screen to access web
  sites

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Use Electronic Verification Screen
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Copy Information on Web Site
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Actions

• Update tables to include web site addresses and
  mark electronic verification
• Add a record for each type to be verified
• Specify a letter for each type in the
  verification set and execute the set
• Use electronic verification screen to access web
  sites

• Copy verification information from web

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Copy Information on Web Site
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Actions

• Update tables to include web site addresses and
  mark electronic verification
• Add a record for each type to be verified
• Specify a letter for each type in the
  verification set and execute the set
• Use electronic verification screen to access web
  sites
• Copy verification information from web

• Paste into electronic verification letter notes

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Paste the Web information into the Verification
Letter Note
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Click on Date and Enter Other Data as Needed and
Youre Done!
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Minimize Labor and Material Costs

• Minimize printing - reducing paper and ink
  consumption
• Minimize long hours filing and pulling files
• Minimize time spent away from your desk no more
  missed phone calls

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Easy Access to Information
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Accessible Trail for QA Review of Verifications
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Outcome

• Work flow process - a model of efficiency
• 1 minute per verification to look up on
  internet, copy and paste
• Easy access to documentation
• Systematic method of verification and QA review
• nothing falls through the cracks
• Meets both JCAHO and NCQA standards

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Responding to Verification Requests for Your
Providers

• Consumes Coordinators time
• Consumes paper, ink, envelopes and postage
• Requires a timely response

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The MSL for the Net Solution
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Benefits

• You control which providers can be accessed
  online for verification
• Most verifications are completed in a timely
  manner with NO intervention from medical staff
  office
• Only special circumstances are handled personally