When to Credential Healthcare Contractors

October 19, 2011 at 12:53 pm Leave a comment

A fundamental definition of “vendor” is anyone who is paid for a product or service. In healthcare, vendor credentialing needs to be done for both the vendor company and for any individual with a direct relationship to the provider.

This seems straightforward enough, but the reality in healthcare is actually complex. And credentialing contract staff members is the epitome of this complexity.

Contracted staff members are essential in healthcare delivery today. And hospitals and ASCs have a number of options in managing the contractor relationship.  In some cases the contractor is paid directly by the healthcare provider. In others, an agency is responsible for recruiting, supplying, and managing qualified contractors.

Who then should the hospital credential?  The individual?  The agency?  Both?

Contracted staffing agencies fall into two categories:

  • CVO (Credentials Verification Organizations): certified by an accreditation agency (e.g. Joint Commission) to conduct their own credential verification and report the credentialing information to their clients (health systems/providers)
  • Non-CVO: not accredited to conduct internal credentialing for their employees

Although CVOs take on the responsibility of credentialing their employees, the hospital still needs to know that the contracted employees are current in any licenses or other requirements and that the CVO itself is currently accredited.  In this case, the healthcare provider should make these requirements clear as part of the contract process.  As far as credentialing goes, the healthcare provider should credentialing the CVO agency as a company, but would not need to credential the individual contractors.

For non-CVOs, the healthcare providers themselves would need to handle any individual level credential verification directly.  This means completing credential verification on contracted employees that may include license to serve patients, background check attestation from the agency, hospital policy acknowledgments and immunizations.

Still trying to figure it out?  Try this decision tree:

Contractor Credentialing Decision Tree

The provider needs to be sure that the credentialing is being done by an accredited organization.  So only when the provider is hiring the contracted staff through a CVO is the provider off the hook for credentialing the individual.  Even then, the provider should credential the agency itself — searching for any sanctions as well as financial due diligence.

Entry filed under: best practices, Joint Commission, vendor credentialing. Tags: .

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