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Oregon to Streamline Provider Credentialing

Jacqueline Fellows, for HealthLeaders Media, August 22, 2013

The state has nearly 18 months to decide on the vendor, user fees, and how much vetting the system will do. It's unclear if the information entered about a physician will go through an initial, cursory validation check, or if it will be taken at face value, which would then require the healthcare facility to continue to check out a physician's background.

Steinberg says St. Charles will continue to scrutinize its prospective physicians regardless.

"I don't see an impact on staffing, because we will still verify the information. It will still be incumbent on each organization to verify that what [physicians] fill out is true."

There is some fear that Oregon's system will drive out credentialing services that are NCQA-certified as Credentials Verification Organizations (CVOs) and also affect some Independent Practice Associations (IPAs), which offer provider credentialing a sideline revenue stream.

Central Oregon IPA (COIPA), also based in Bend, does credential providers, but is not worried about the new system's effect.

"It's not a moneymaker for us," says John Ryan, executive director for COIPA, which represents more than 650 physicians and practitioners. "It's mainly to serve the community, since we have the infrastructure and staff."

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4 comments on "Oregon to Streamline Provider Credentialing"


Kendra (8/30/2013 at 4:05 PM)
Arkansas has had a mandate to for all hospitals, insurance companies, and other facilities to use CCVS(Centralized Credentialing Verification Service)since January 1,2002. I'm glad to hear other states are doing the same.

Elizabeth (8/28/2013 at 5:19 PM)
bettynoyes: Credentialing isn't something that is subject to commentary or opinions. The credentialing process has to do with validating a professionals, credentials. Whether or not their license is valid does not require commentary. There are other parts to the process of, say, hospital medical staff appointment and privileging which DO take into account peer references, clinical peer review data, practitioner's health and ability to play nice with others, etc. Those somewhat more ephemeral qualities would probably not be part of a credentialing database. Then there are other aspects that are investigative and somewhat subjective. Criminal background check, NPDB check, Google check and on and on. Maggie: I'm with you, I'm very curious about the particulars of this database. I live and do credentialing in TX so only a matter of interest to me. Oregon may start a trend.

Maggie (8/27/2013 at 2:39 PM)
I'm happy to see the legislature involved those who acutally perform the work...the Medical Services Profession (CPCS/CPMSM). I'm wondering if this similar to the CAHQ application ~ a central repository for data ONLY and the credentialing (PSV) would still be performed by each organization. Or will it be data AND PSV documents? Who validates the data or updates it? What about the organizations that spent tens of thousands of dollars on their own software? Will the data interface and what is the cost? I guess I have a lot of questions don't I? (even that was a question =) I'll go read the bill.