Becker's ASC Review

22 EXECUTIVE BRIEFING 1 EXECUTIVE BRIEFING H istorically, provider credentialing has been slow to evolve. But technology is shifting credentialing from an arduous, manual process to one that is automated, streamlined and more efficient. Becker's Healthcare recently spoke with two leaders from Modio Health — Dawn Goser, senior director of product, and Rich Rupp, senior director of engineering — about the current provider credentialing landscape, future trends and what organizations can do to improve their processes. Reimagining provider credentialing: An urgent need There is considerable variability in how organizations execute credentialing processes today. "There's a real need for a flexible and scalable solution that can be tailored to meet organizations' changing needs," Ms. Goser said. "This is a challenge that has hindered adoption of provider credentialing systems." In addition, credentialing coordinators deal with significant administrative burden, as long credentialing times translate into increased frustration for providers and those responsible for the credentialing process. "There's inherent friction," Mr. Rupp said. "It takes on average between 60 and 120 days to complete credentialing for a provider. If errors arise along the way, it drives that average up." Today's technology, however, can streamline the credentialing process for providers and coordinators while delivering quality results and mitigating risks. Recurring tasks that add friction to provider credentialing are prime opportunities for automation. When credentialing coordinators run a license check, for example, it's not uncommon for them to go to a website, run a search, transcribe the results, take a screenshot and create a PDF, and then store the PDF. With the right technology, those steps can be reduced to a single action. A platform like Modio's OneView® can run the search, grab the data and source verification, and store it in the cloud - all with a single click. Healthcare organizations can then integrate this technology at scale to automate most processes associated with credentialing. With this approach, organizations are seeing between 35 and 45 days on average to complete provider credentialing. Modio's OneView technology allows access to important credentialing information from anywhere. It gives credentialing teams access to hundreds of integrations with state, federal and nation-wide credentialing organizations to automatically gather and store real-time, primary sourced information like DEA and state licensure, NPI numbers, CAQH data, OIG exclusion status and more. "By applying innovation, it's possible to drive down inefficiency across an entire population of users," Mr. Rupp said. The importance of interoperability A critical step toward real-time credentialing is creating centralized, standardized repositories of provider information. These ensure consistency and reduce redundancies across systems. Interoperability is another key enabler; it creates seamless communication between credentialing systems. This is sometimes easier said than done. "When you look across the credentialing industry, every data type has very few players with modern programmatic ways to retrieve information. Even the major players rely on antiquated ways to interface with the data," Mr. Rupp said. Modio provides a self-managed path that automates the credentialing verification process of credentials. Instead of having to bring multiple solutions together, Modio includes all the necessary features for managing physician credentialing, including renewal tracking, expiration monitoring, and secure document storage. The future of provider credentialing: Where are we headed? 2025_Jan_Modio_EB_v2.indd 1 2025_Jan_Modio_EB_v2.indd 1 07/01/2025 17:27 07/01/2025 17:27

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