Credentialing for CVO refers to the use of a credentials verification organization (CVO) to perform medical credentialing for a healthcare organization or practice. CVOs verify a provider's credentials.
Credential verification organization obtains primary source verification on behalf of the organization. After verification, providers can enroll in the health plans of payers so that they can be reimbursed.
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The credentialing of healthcare providers may include the verification of their education, training, experience, and any other qualifications that can be used to confirm their status. CVOs acquire documents from the primary source, such as state licensing boards and educational institutions.
They do not accept self-reported data. CVOs have the ability to obtain records from providers that include historical and current records of exclusions and sanctions as well as other disciplinary actions and abusive activity.
It can take time to verify provider credentials. Primary sources must be verified, identity matching must be confirmed and providers must be monitored regularly to notify organizations of any changes. Organizations that don't have the staff or resources to do this kind of screening and monitoring can benefit from a trusted, experienced CVO. Insurance companies may deny coverage if the CVO is not properly credentialed.
Organizational workflow can be disrupted (e.g. file backlogs and unfilled clinical positions, revenue loss, etc.). Patients are at the greatest risk if their care is compromised. You can even search online for more information about cvo credentialing companies.