What You Need to Know About Guidelines from GAO

Proper credentialing is necessary for the healthcare industry.

If you're working as a physician in the healthcare industry, you're required to maintain provider credentialing. Although the state regulations vary, you're only allowed to perform the privileges you've been granted. These functions are determined during the credentialing process.

To maximize satisfaction and care, the Government Accountability Office (GAO) has determined there's a "greater focus on credentialing needed to prevent disqualified providers from delivering patient care" within the Veterans Health Administration (VHA). Here's what you need to know and how you can prevent it from happening to you.

The Veterans Health Administration's role

The VHA has been accused of retaining and hiring ineligible providers. Hiring staff and others missed disqualifying facts within the national database and didn't understand the licensed healthcare providers were ineligible if their license was revoked or surrendered in another state. Upon these findings, the GOA provided the following seven recommendations:

• Proper training for hiring staff and others who review and determine credentials.
• The Under Secretary for Health can create policies regarding the DEA.
• The Under Secretary for Health can identify and review providers who've surrendered their DEA registrations, or had them revoked.
• The Under Secretary for Health will need to confirm the Veterans Integrated Service Network (VISN) reviews are being documented.
• The Under Secretary for Health will need to confirm the VHA office is monitoring to ensure proper reviews of credential files.
• There should be a periodic review of provider licenses and report findings to delegated offices.
• The Under Secretary of Health can direct the Office of Quality, Safety, and Value (QSV) to compile and distribute amongst all facilities the best practices used to identify and address unfavorable licensure issues for physicians.

The action taken on these recommendations remains open for the GAO to decide upon. As they carefully determine their next move, you should ensure you're doing the same.

How to use this information for your own provider credentialing

As a healthcare provider, there are some things you can learn from this review. One major take-away is ensuring you maintain the proper licenses and credentials. If you go against state regulations and have yours revoked, it can end your career.

As noted in the review, the GOA is recommending that VHA focuses more on weeding out ineligible providers. Those who are licensed in one state but revoked in another are considered unqualified. You can avoid this by ensuring your credentials are current and you're following all the regulations.

When the time comes for renewal or changing facilities, know what's required by the state and facility ahead of time. By meeting all the standards early on, you can speed up the long provider credentialing process. On average, the credentialing process can last from weeks to six months.

There are resources available to guide you along. From affordable CEs to a free credential management platform, you have no reason to put it off. This can make or break your career.

Stay current with Intiva Health

You don't have to worry about facing backlash when you remain current with your credentials and education. It's your responsibility to know what's required and to maintain it. By accessing a credential management platform that can share and timestamp your paperwork, you'll find it easier to navigate the provider credentialing process.

Ready Doc offers all of that and more. It can speed up the provider credentialing process, saving you time and money. This free platform is easily accessible by both you and your facility.

You can access this credential management platform, continuing education courses, and more with the click of a button. Visit our website to learn more.