Importance of Primary Source Verification Credentialing

Healthcare patients place their trust in providers during moments of vulnerability. Failing to deliver quality care can have profound consequences. That’s why primary source verification credentialing (PSV) is at the heart of screening qualified providers.

By recruiting ethical and qualified professionals, healthcare organizations can bolster patient safety, reduce liability risks, and cultivate trust within their patient community. PSV credentialing makes this possible.

Get best practices to improve your PSV process in this on-demand webinar.

What Is Primary Source Verification Credentialing?

Primary source verification (PSV) credentialing ensures the accuracy of a healthcare provider’s credentials and qualifications. This method entails verifying key information, such as education, training, licensure, certification, work history, and other relevant details, directly from the originating source, be it an educational institution or an accrediting organization.

Credentials Requiring PSV

The precise prerequisites for PSV may vary depending on the healthcare organization, jurisdiction, and the nature of healthcare services offered. Nonetheless, the following types of credentials and qualifications generally necessitate PSV credentialing:

Licensure
Certifications
Education
Work experience

This comprehensive process is indispensable for healthcare organizations to ensure that their providers are not only qualified but also trustworthy. By meticulously confirming the authenticity and accuracy of a provider’s credentials and qualifications, healthcare organizations commit to delivering high-quality care while maintaining the trust and confidence of their community.

Methods for Conducting PSV

When it comes to verifying a new hire’s credentials, the approach can vary based on the resources and time available for primary source verification credentialing. Below are examples of how to effectively authenticate credentials:

Direct Contact: A widely adopted approach for completing PSV involves direct communication with the institution or organization responsible for issuing the credentials. This typically occurs through phone calls, emails, or online interfaces.
Digital Verification: Another avenue is digital verification platforms that grant access to verified provider information and credentials from multiple sources. They often employ artificial intelligence and machine learning algorithms to ensure information accuracy.
Third-Party Verification Services: These services have access to primary source data and can efficiently expedite the verification process.
In-House Verification: Many healthcare institutions opt to perform PSV in-house, utilizing their internal resources alongside credentialing software or platforms to manage the process internally.

Overcoming Challenges in the Verification Process

While PSV credentialing is crucial for healthcare organizations to guarantee the precision and legitimacy of a provider’s credentials and qualifications, several challenges can emerge during the process. Common issues with PSV include:

Time-Consuming: Collecting and verifying necessary information can be a time-consuming endeavor, potentially delaying the onboarding of new providers and impacting the organization’s operational efficiency.
Inconsistent Standards: Variations in standards and requirements for PSV across different organizations and jurisdictions can complicate the process, potentially leading to errors or inconsistencies in the information collected, thereby affecting accuracy and reliability.
Credentialing Errors: Errors or inaccuracies may arise due to mistakes made by manual processes, as well as incomplete or outdated records. Such errors can lead to delays in provider onboarding, potential liability issues, and other operational inefficiencies.
Compliance Risks: Failure to complete PSV or inaccuracies in the verification process can expose healthcare organizations to compliance risks, resulting in fines, legal liabilities, or damage to their reputation.
Cost: Primary source verification credentialing can be costly, especially for organizations with a large number of providers to verify. Expenses stem from the time and resources required for information collection and verification, as well as fees charged by credentialing and verification organizations.

Though PSV poses its share of challenges, it remains an indispensable component for ensuring the qualification and reliability of healthcare providers. Partnering with a compliance specialist lt can help eliminate unnecessary delays, enhance efficiency, and improve accuracy in the PSV process while reducing staff compliance risks.

How to Streamline Primary Source Verification

Despite the challenges associated with PSV, it is undeniably worth the effort. By guaranteeing that healthcare providers possess the appropriate qualifications and experience, healthcare organizations broadcast a message to the world – that their facility’s physicians adhere to the highest standards of professionalism and integrity.

Here are ways to streamline your verification process:

Store provider data together in one online location for easy access and to quickly identify missing information
Track all actions so you know what phone calls have been made and all follow-up is documented
Automate parts of the process, such as exclusions monitoring or DEA license verification
Pull already verified data from a trusted source, such as the CAQH ProView profile
Request provider documents electronically and rely on automated reminders to ensure the provider shares all documents

Primary source verification credentialing is not just a healthcare protocol; it is a safeguard for patients, a shield against liability, and a testament to an organization’s commitment to professionalism and integrity. While it may present challenges, its impact on public health and healthcare excellence cannot be overstated.

MedTrainer: A Proactive Approach to Healthcare Verification

MedTrainer offers both software and services to help streamline the PSV process. MedTrainer software allows providers to upload their documents directly into the platform, automates parts of the verification process, and tracks all actions for real-time status updates. MedTrainer managed services can handle the entire PSV process, freeing your staff to focus on other tasks. By using a platform like MedTrainer, healthcare organizations can reduce the administrative burden of the PSV process, improve accuracy and consistency in verifying provider information, and accelerate the onboarding of new providers. This can result in improved operational efficiency, reduced risk of liability, and a more positive experience for providers and patients.

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