A medical provider credential verification service company had been using a DOS-based database system for a number of years. Because of changing requirements to the credential verification process and improved technology, they needed a new and better solution. The company that developed their DOS-based system was unwilling to provide the necessary product support, so the service company contacted System Solution Strategies, Inc.
Verification of medical credentials is required by government regulations, medical institution policies and insurance company requirements. The task requires comprehensive review and verification of all pertinent credentials before a practitioner may be hired. The process then requires periodic review of all credentials that may change or expire, such as DEA licenses, training and insurance policies, as well as any history of malpractice claims. If an office does not automate the process with a database system, it can be very time-consuming and labor-intensive.
We developed a new database and program to use and manage the data for this company. As part of the process, we also developed a program to read the data from their old DOS-based system and import it into our new system so they would not have to reenter all the data they had accumulated.
The Professional Verification Management System (PVMS) allows our client to enter all pertinent data for each practitioner.
The data entry format is designed to allow the user to easily follow the standard application form and enter each item of data precisely one time. All data items that might be used many times (such as medical facilities, insurance companies and educational institutions) are maintained in lookup lists.
The most important functionality in the PVMS program is the feature that automatically selects practitioners for periodic reappointment reviews and reminder notices. Rather than having to maintain a separate list or schedule, the user needs only to select the program's function to automatically identify medical practitioners due for reappointment or whose licenses or insurance policies are due to expire. The user can then select the program option to print the necessary application forms, cover letters, reminder letters and source verification requests.
The user may also print individual letters and forms.
When our client receives a verification letter or completed application, they need only double-click the appropriate space on the work list to indicate completion of this part of the process. The program automatically updates the appropriate tracking data.
The PVMS program also provides a security feature to allow our client to control employees' access to the data. Some users are allowed only to update practitioner records. Others may also print reports and revise the lookup listings.
The system saves our client countless hours spent poring through files to identify practitioners, modifying form letters for each individual practitioner or verification source, and managing the details of credential verification. Further, the system pleases the individual practitioners because they no longer have to enter the same information on each application and reapplication.