As a rule, hospital credentialing is the most intensive credentialing process medical providers undergo.
According to The Benefits of Outsourcing for Hospital Credentialing (Note: This article is directly connected to an advertisement for a California CVO.)
“The amount of staff time and the expense of researching every medical provider can be heavy, draining resources from other administrative functions, and requiring experienced staff and access to research resources. Yet hospitals have been slower than other medical organizations to outsource the credentialing process, despite potential benefits: faster turnaround time, cost-effectiveness, and savings in staff time and training.”
So, the question is, when is outsourcing the best solution? Some considerations:
Outsourcing is never a good solution if the work of the Credentials Verification Organization (CVO) the hospital utilizes isn’t accurate, responsive, and timely.
It is also necessary to consider how many other responsibilities the medical staff office handles. If the department’s primary responsibility is credentialing and they have adequate staff and resources to perform those responsibilities, it may not make sense to consider outsourcing.
However, if the medical staff/credentialing office also handles meeting management for multiple committees and boards, CME program administration, medical library oversight, newsletter publication, Allied Health oversight, medical staff/hospital social functions, etc., credentialing may not receive the attention it deserves. Outsourcing may be a valid consideration.
As you know if you work in this field, credentialing is just a part of what is required to determine whether a provider (either new to your staff or undergoing a two-year reapplication) is qualified and competent to care for patients in the organization. Real time and attention must be spent on privileging.
Credentialing determines who the provider is, what education and training they’ve had, and what reputation they’ve developed among their peers. Privileging establishes the detail of what specific procedures the individual is permitted to perform while treating patients in the hospital setting.
Privileging can never be outsourced. Those decisions require thoughtful consideration and evaluation by peers, and may often depend on what resources, both technical and professional, are available at the treatment location.
NOTE TO PATIENTS: If a physician wants to perform a complex procedure on you in the office rather than in the hospital, it may be because the hospital is unwilling to grant him/her the privilege. Find out whether the physician also has permission to perform the procedure in the hospital, if not, consider that a warning flag.