Provider Enrollment, Credentialing and Primary Credential Source Verification

KSI knows that time is money. Accurate, rapid credentialing is key to profitability. Working across the healthcare industry spectrum, we ensure that credentials are correctly submitted and verified.

CVO

Time-consuming. Critical to upholding the highest standards of patient care. Negative impact on the bottom line. According to industry sources, delays in provider credentialing can cost a hospital over $900,000 in as few as six months, while the cost to verify each providers' credentials can exceed $250 in out of pocket costs alone, not to mention the cost of valuable administrative time.

As an accredited Credentials Verification Organization, KSI knows that accurate, complete and timely verification of provider credentials is critical to maintaining the highest standards of patient care. With proven expertise verifying credentials to the standards demanded by the NCQA, URAC, Joint Commission and AAAHC, KSI's PCVS team will verify all primary sources including:

  •  State licensure
  •  Education, training, and board certifications
  •  DEA/CDS certification
  •  National Practitioner Data Bank
  •  OIG sanctions
  •  Malpractice claims history
  •  Work history
  •  Medical Board sanctions
  •  Meet joint commission or NAQA standards

Privileging

Duplicative. Ongoing. Expensive. With constantly evolving industry standards, privileging has become a headache that results in average internal costs per provider in excess of $1200, according to industry sources, directly impacting practice profitability. And with average privileging cycles lasting as few as two to three years, the cost of maintaining relationships with the right secondary and tertiary care facilities is a fast-growing growing indirect practice cost.

Without advanced credentialing software, and expertise to ensure that documentation is accurate and complete, the amount of time necessary to ensure that practitioners keep their privileges up to date detracts from patient care.

Payer Credentialing

Inefficient. Lengthy. Costly. Keeping credentials up to date with the right network of payers is key to maximizing revenue. Staying on top of ever-changing network and Medicare/Medicaid requirements is critical.

KSI works with providers of all specialties to ensure that network and federal program enrollment is complete and up-to-date. Using NCQA and URAC guidelines for primary source verification, we are able to complete enrollments in 45-60 days, accelerating your revenue potential.

Reliable. Cost-effective. Accurate. Efficient. Fast. High touch Whether you are a single practitioner, or a medical group, hospital or health plan, KSI's high touch service combines efficiency and customer service, speed and competitive pricing—all delivered through easy to use enabling software which eliminates duplication and rework.