1. UNCOVERING THE FAQs OF CVOs:
Credentialing Verification Organizations
Tuesday, May 21, 2019
Donna Goestenkors, CPMSM - President
Stephanie Russell, BS, CPCS, CPMSM
Team Med Global Healthcare Consulting

2. Donna Goestenkors, CPMSM
PRESENTER
Donna Goestenkors, CPMSM 43
Years of Service

3. Stephanie Russell, BS,CPCS, CPMSM
PRESENTER
Stephanie Russell, BS,CPCS, CPMSM 34
Years of Service

4. WORKING TOGETHER…

5. OBJECTIVES
Describe the primary benefits of CVOs.
Distinguish between internal (system) CVOs and external (commercial) CVOs.
Track the top 10 CVO challenges and solutions.

6. PREPARE YOURSELF

7. MSP COMPETENCY FORMULA

8. MSP CORE COMPETENCY

9. MSP CORE COMPETENCY SKILLS Efficiency Core: ~Credentialing Management
CAREER
Power
PERSONAL
Effectiveness
SKILLS
Efficiency Core:
~Credentialing Management
~Privileging Management
~Practitioner Competence Mgmt.
{privileging, FPPE, OPPE}
~Compliance Management
~Enrollment Management
~Healthcare Quality Data Management
~Practice Management
~Managed Care Management
~On/Off-Boarding Management
~Office Management
~Consulting Management
~Document Management
~Merger/Acquisition Management
~Lean Management
~Technology Management
~Relationship Management
~Development Management

10. WHAT DOES CVO MEAN?
Credentials Verification Organization/ Office

11. WHAT IS A CVO?
“A CVO is defined as any organization that provides information on an individual’s professional credentials.”
Sometimes called CVS – Centralized Verification Services
Source: where_credentialing_booklet.pdf

12. TYPES OF CVOs Internal External System Regional National
Local Medical Society
Others?

13. POLL QUESTION #1
Are you a CVO?
Yes No

14. POLL QUESTION #2
Do you use a CVO?
Yes No

15. POLL QUESTION #3
Do you wish you used a CVO?
Yes No

16. CVO RATIONALE

17. ADVANTAGES Cost Reduction Increased Efficiencies Centralized Resources
Standardized Process
Faster Turnaround Time
Culture Objectivity
Focus on Privileges
vs. PSV

18. DISADVANTAGES
Loss of MSP Control
Lack of Respect for Facility Culture
Increased Bureaucracy - Sometimes

19. TOP 10 CVO CHALLENGES

20. STAFFING CHALLENGES
C-Suite “Believes” Full Time Equivalent (FTE) Neutral
Determination of Who will Do What?
To Be Determined #1

21. #1 STAFFING SOLUTIONS Educate C-Suite Regarding Responsibilities
Efficiencies Need to be Identified
Not Less Staff – Better Use of Resources #1

22. #2 CONTROL CHALLENGES Define Responsibilities/Work Flow
MSP Paradigm Shift
”Doing It All” to Shared
Lack of Control - Fallacy #2

23. #2 CONTROL SOLUTIONS Collaborate – Especially During Set-Up
MSPs Remain the Expert
Validate Decisions
*Resources
*CMS/TJC/HFAP/DNV/NCQA, etc. #2

24. #3 QUALITY CHALLENGES Document ”Ownership” Process “Ownership”
Auditing Process
Turn Around Times (TATs) #3

25. #3 QUALITY SOLUTIONS Auditing Process – by BOTH Parties
TATs Defined/Acceptable
Process Defined that is Acceptable to BOTH Parties #3

26. PRIVILEGES CHALLENGES
Ensuring Delineation of Privileges (DOPs) Converted Properly
Maintenance of DOPs
Compliance with Privilege Criteria #4

27. #4 PRIVILEGES SOLUTIONS DOPs Defined/Set by MSSD not CVO
MSPs Remain the Experts on the Criteria
Determine Who Collects Criteria – CVO or MSSD? #4

28. #5 POLICIES CHALLENGES CVO Needs MSSD Needs Stakeholder Needs
Regulatory/Accreditation Compliance #5

29. #5 POLICIES SOLUTIONS Write Policies Together – MSSD & CVO REMEMBER:
The MSSD is the Customer!
Collaborate/Negotiate Practices that Both Parties Can Live With #5

30. COMPLIANCE CHALLENGES
Keeping Polices/Forms Updated
Survey Process – Who Does What?
Efficiency vs. Compliance – Don’t Cut Corners. #6

31. #6 COMPLIANCE SOLUTIONS Educate CVO/MSSD
Process to Maintain Compliance
Team Work!!!!! #6

32. EVALUATION, RECOMMENDATION & ACTION CHALLENGES
TATs
Medical Staff Review Process
”Complete” Application Definition – CVO? MSSD? #7

33. EVALUATION, RECOMMENDATION & ACTION SOLUTIONS
Set Realistic Time Frames
Educate C-Suite – PTB
Define Parameters – CVO/MSSD #7
PTB = Powers that Be

34. COMMUNICATION CHALLENGES
CVO ”Way” vs MSSD “Way”
C-Suite & Medical Staff Leaders
Applicants #8

35. COMMUNICATION SOLUTIONS
TALK – Don’t  – Verify in Writing
Educate – Educate – Educate
Define Instructions – Process Not Always “Intuitive” #8

36. STANDARDIZING/CENTRALIZING CHALLENGES
CVO vs MSSD “Way”
Time Sensitive “Needs”
Maintenance – Everything! #9

37. STANDARDIZING/CENTRALIZING SOLUTIONS
Understand Each Other’s “Worlds”
Take Time to Make Time – Especially During Setup
Keep Current! #9

38. AUTOMATION CHALLENGES
Testing
Rollout/Implementation
#10

39. AUTOMATION SOLUTIONS
How to Review Documents – No Assumptions!
Test at All Levels: CVO, MSSD, Medical Staff, Office Beta Sites
Allow Extra Time During Rollout to Address “Issues”
#10

40. TIPS FOR A SUCCESSFUL CVO
Communication
Audits
Evaluation
Quality

41. TIPS FOR A SUCCESSFUL CVO - COMMUNICATION
Customers
Client
C-Suite
Practitioners
Other

42. TIPS FOR A SUCCESSFUL CVO - COMMUNICATION
Set Expectations
Theirs
Yours
C-Suite

43. TIPS FOR A SUCCESSFUL CVO - COMMUNICATION
Policies/Processes
In Writing
Available for Reference
Keep Current
Other

44. TIPS FOR A SUCCESSFUL CVO - COMMUNICATION
Continuous Communications
Completed Files
Issues
Meetings

45. TIPS FOR A SUCCESSFUL CVO - AUDITS
At the CVO
With the Client
Practitioner

46. TIPS FOR A SUCCESSFUL CVO - EVALUATIONS
Process
Team
Practitioner Level
C-Suite
Surveys
Other

47. TIPS FOR A SUCCESSFUL CVO - QUALITY
Audits Will Reflect Your Performance
Surveys Will Provide Feedback From Client/Providers
Continuous Review of Processes
Take Time to Make Time
Software System
Keep it Current
An IT Department that KNOWS Credentialing
Interfaces that Make Sense

48. SUMMARY FOR SUCCESS Communications Audits Evaluations Assessments
Quality

49. SUMMARY FOR SUCCESS
This Photo by Unknown Author is licensed under CC BY-NC-ND

50. POWER THOUGHT

51. “Your Roadmap for Managed Care” Next
MARK YOUR CALENDAR!
“Your Roadmap for
Managed Care”
Tuesday, June 18, 2019
Noon – 1:00 p.m. CST
Next
MARK YOU CALENDAR!

52. Donna Goestenkors, CPMSM
SPEAKER CONTACT INFORMATION
Donna Goestenkors, CPMSM
Team Med Global Consulting, LLC
Phone: (618)
Website: TeamMedGlobal.com
facebook.com/TeamMedGlobal
linkedin.com/DonnaGoestenkors
twitter.com/TeamMedGlobal

53. SPEAKER CONTACT INFORMATION
Stephanie Russell, BS, CPMSM, CPCS
Team Med Global Consulting, LLC
Phone: (719)
Website: TeamMedGlobal.com
Regional Director Medical Staff Services and Credentialing
UCHealth Colorado Springs
Southern Region

54. THE MSP YOU ARE MEANT TO BE!
5/28/2019

55. SERVICE LINE
5/28/2019

56. COMMUNITY
5/28/2019

57. COMMUNITY
5/28/2019

58. SERVICE LINE
5/28/2019

59. RESOURCES Team Med Global Healthcare Consulting Lisa Deterding
5/28/2019
Team Med Global Healthcare Consulting
CVO Team
Industry Interviews
Research
Lisa Deterding
PowerPoint Design Consultant

60. CAREER DEVELOPMENT RESOURCE
Features include:
Frequently asked questions by MSPs
Sample job descriptions, systematic
Assessment tools, planning techniques & strategies for effective performance
Real-life stories to illustrate specific points
Order your copy:

61. CREDENTIALING TOOL
Order:

62. TMG – NATIONAL PRESENCE

63. MSP CREED

64. MSP CODE OF CONDUCT