Credentialing

A Guide to Healthcare Vendor Credentialing | Hospital Credentialing

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January 17, 2023

The first responsibility of every healthcare providing facility is to ensure the safety of all patients under her care.

To effectively discharge this duty, The facility must put in systems to monitor the training, background, licenses, and immunizations of regular visitors and external healthcare service providers who frequently work with medical staff.

This article takes you on a journey on how healthcare facilities manage the process that ensures the credibility and competence of their vendors.  

What Is Healthcare Vendor Credentialing?

Healthcare vendor credentialing is the process and measures healthcare administrators go through in verifying the credibility and competence of their third-party suppliers and contractors.

They do this to make sure that vendors have the right certifications, licenses, training, and immunizations to deal with direct or indirect patient care.   

A Brief History Of Healthcare Vendor Credentialing

As healthcare facilities and patient information became increasingly complex, structured measures were needed to monitor them. This led to healthcare vendor credentialing. The demand began with pharmaceutical companies due to concerns around the relationship between Pharmaceutical reps and Physicians.

There were also issues around security in hospitals as healthcare facilities enforced no strict security protocols.

The advent of HIPAA and OSHA medical laws necessitated a review of this lapse in healthcare operations.

Healthcare vendor credentialing then grew to become a standard requirement for any Healthcare industry Representatives (HCIR) to access any medical facility or hospital.

The growing necessity for healthcare vendor credentialing is also owing to the compliance standards put in place by so many governing bodies of healthcare organizations, including the American College of Surgeons (ACS), the Association of Operating Room Nurses (AORN), and the Joint Commission.  

These bodies put the compliance standards in place to ensure quality and safety of care.

The Importance Of Healthcare Vendor Credentialing

Given that most of the supplies vendors provide are used directly or indirectly to influence patient recovery, regulatory standards are necessary to check the quality of vendor services. The resultant effect of the quality of third-party services can significantly impact your healthcare facility's legal and financial standing.

Not only does compliance violation cost the healthcare industry millions on an annual basis, but it can also diminish the local community’s trust. This situation constitutes a financial and reputational liability to your healthcare facility.

Medicare and Medicaid have strict compliance policies guiding the provision of external services to patients. Violating these rules can make your healthcare facility run the risk of facing penalties, fines, and legal litigations.

The primary cause of these violations is when your healthcare facility doesn't undergo the correct procedures for the credentialing process.

Some other importance of healthcare vendor credentialing is;

  • More excellent protection of your patient from infectious disease and technical complications
  • A higher level of control over healthcare facility operations and supply chain
  • Improved security of patient privacy   

Vendor Credentialing Process: Who Has To Participate?

The core set of people that should be screened to gain access to certain areas of the hospital are:

  • Vendors
  • Suppliers
  • Sales representatives

An additional class of individuals who may need to be credentialed are contractors, students, researchers, volunteers, consultants, etc. 

The Healthcare Organizations' Credentialing Process.

Most healthcare facilities implement healthcare vendor credentialing with the help of a third-party provider like Float Care. It is called vendor credentialing service. This service is used to seek out needed vendors and check them out for compliance.

The credential service provider requires healthcare vendors to register on their platform. This grants the vendor access to the healthcare facility that hired the credentialing service.

Required Information In Healthcare Vendor Credentialing

While health care facilities might have slightly different certification and credential requirements of vendors seeking to access their patients and facilities, here are some standard requirements for vendors:

  • A Drug test
  • An agreement to ensure compliance with facility policies
  • Proof of immunizations, like measles, hepatitis B, rubella, mumps, and the flu
  • A valid ID card and Tax identification number.
  • Proof of education and training
  • Verification that the vendor is not on any exclusion lists 

Vendors are listed on an exclusion list if they have violated Medicare or Medicaid policies and are subsequently sanctioned or penalized. It is known as exclusion monitoring.

Medicare or Medicaid may fine or penalize a healthcare facility for working with a vendor on the exclusion list.

Problems Facing Healthcare Vendor Credentialing

Credentialing healthcare vendors have become increasingly relevant today, yet there are still some challenges.

One of the biggest problems of HCIRs and healthcare organizations regarding healthcare vendor credentialing is the lack of standardization. On top of this, different hospitals require different credentials, and there is no standardized set for these credentials.

Also, there is no centralized database where healthcare centers can check vendors' credentials.

Lack of standardization in healthcare vendor credentialing can cause different forms of problems for the occupational health sectors and facilities.

If a vendor visits a facility with a different credential requirement than what the vendor has, it can cause a delay in supply or service delivery.

Getting the right set of credentials for a facility could take a lot of time, depending on the facility's requirements.

 In cases of emergency surgeries or complications where the service of a third-party vendor is needed, and the vendors' credentials are found incomplete, the patient's life may be at risk due to the lags in the credentialing process.

Credentialed vendors also mention some privacy concerns. The information isn't centralized. For vendors who work with so many hospitals, this is a huge source of worry. 

Without a central location for data storing, it can be worrisome for a vendor who visits several healthcare facilities. The management of personal information will always be an issue.

The Float Care Solution for Credentialing Vendors

The lack of standardization of vendor credentialing, concerns about privacy, and differences in hospital requirements have contributed to the creation of vendor credentialing services that offer this service at one location.

As a reputable vendor credentialing company, Float Care serves as a one-stop shop for healthcare industry representatives. Our credentialing solution makes storing and accessing credentials much more accessible than visiting five or more locations to verify individual credentials. 

You can save time and money with our credentialing service.  

Sign up today!

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