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TPQVO is located in Chattanooga, Tennessee, where it has
provided credentialing services since July of 1998. TPQVO was
created as a limited liability company that merged the Chattanooga and
Hamilton County Medical Society's and the Knoxville Academy of Medicine's
Central Verification Services. Those services began operations
in 1991 and 1995 respectively, making TPQVO one of the oldest credentials
verification organizations in the business.
TPQVO is an NCQA certified credentials verification organization
(CVO) that provides credentials verification services to hospitals, ambulatory
surgery centers, health plans, networks and other healthcare
organizations. TPQVO provides
application processing and credentials verification for medical staffs
defined as medical doctors (MD, DO), podiatrists (DPM), dentists (DDS, DMD)
and clinical psychologists (PhD) and allied health practitioners.
Allied health practitioners are defined as licensed independent
practitioners or licensed healthcare practitioners who practice under the
supervision of a physician or dentist.
Our clients include hospitals, healthcare networks, IPAs,
surgery centers, physician offices, and local and
state government departments throughout the country.
TPQVO Ownership
TPQVO is owned by the Knoxville Academy of Medicine,
Chattanooga-Hamilton County Medical Society and the Tennessee Medical
Association. The TPQVO Board of Governors is elected by its
owner-members to govern the company.
2010 Board of Governors:
Pete Kelley, MD, Chairman, Chattanooga and Hamilton
County Medical Society
Yarnell Beatty, JD, Secretary, Tennessee Medical
Association
Charles Handorf, MD, Tennessee Medical Association
John Neff, MD, Knoxville Academy of Medicine
Mel Twiest, MD, Chattanooga and Hamilton County
Medical Society
Rae Bond, Chattanooga and Hamilton County Medical
Society
Physician and Other Healthcare Provider
Database
Currently, TPQVO maintains approximately 6,500
physician, dentist, and other healthcare provider credentials
files. The vast majority of practitioners maintained in TPQVO files
are physicians (MDs/DOs). These files are processed for initial
credentialing and recredentialing for over 55 hospital, health care
network, surgery center, federally qualified community health
centers, public health service, nursing home and
home health clients throughout the U.S.
Credentials Verification Standards
TPQVO follows the credentials verification standards
set by the National Committee on Quality Assurance (NCQA) for
managed care organizations, the Joint Commission for hospitals and
surgery centers, and Accreditation Association for Ambulatory Health
Care (AAAHC) for surgery centers. Some hospitals define higher
credentials verification standards through medical staff bylaws than
those required by Joint Commission. TPQVO will work with those
clients to meet the higher standards whenever possible.
In addition to application processing and primary
source verification, TPQVO monitors expiring documents and licenses
(DEA registration, insurance certificate, licenses) and obtains new
documentation from providers. This document update service is
provided for no additional cost to clients using TPQVO for
processing recredentialing information. Also, TPQVO monitors the
HHS Office of Inspector General Medicare/Medicaid sanction reports
and state licensing board disciplinary actions and notifies clients
of any adverse information regarding practitioners on their current
rosters.
Policies and Procedures
TPQVO operates under extensive policies and
procedures specifying the credentials verification process, primary
sources queried, record confidentiality, security of paper and
electronic records, quality improvement and other organizational
functions and structure. Excerpts from the Policy and Procedure
are available upon request.
Additionally, TPQVO develops and implements annually
a Quality Improvement Plan. Results from continuous performance
measurement are described below.
Credentialing Operations Performance
As part of its quality improvement program, TPQVO
tracks the time it takes to complete credentials verifications. The
data tracked from TPQVO’s inception in 1998 through 2009 show only a
small percentage of verifications exceeded TPQVO’s benchmark of 90
days for appointments and 60 days for reappointments.
The data shown below represent time for processing
files after receipt of a completed application for initial
appointment or reappointment for 2009. During this time, TPQVO
processed about 642 unique physicians and 342 allied health
practitioners for initial credentialing and 1,778 physicians and 590
allied health practitioners for recredentialing. Most of the files
processed are processed using Joint Commission or AAAHC standards.
Verifications are complete only when primary source
verifications are obtained or there are three attempts to verify the
information. (In those cases, secondary sources acceptable to NCQA
and files closed as “incomplete” are not included in the data
displayed above. Clients are notified of all missing documents or
information that could not be verified. Joint Commission standards
will be used or clients are notified of outstanding verifications.)
Signatures on attestations are checked to make sure they are current
to maintain overall timeliness of file processing. If a signature
is outdated, TPQVO will obtain an updated signature from the
applicant to maintain the 120-day wrap around the application and
verifications. Even if an application attestation is refreshed in
this way, total days are tracked from the receipt of the completed
application.
Another measure used for quality improvement purposes
is mean days for file completion. File completion is measured in
calendar days, beginning with the receipt of a completed application
and ending with the receipt of the last verification and the closing
of the file. Average processing times were 48 days for
physician initial appointment, 33 days for physician recredentialing,
51 days for allied health initial appointment, and 32 days for
allied health recredentialing. (Days are stated in calendar days,
not business days.) These averages include files processed by all
credentialing standards, including more extensive Joint Commission
and AAAHC-processed files. Average processing times for NCQA-only
files are considerably lower. Most files processed using NCQA
standards are completed within 1 business day of TPQVO’s receipt of
the completed application.
PROCESSING TIMES FOR PHYSICIAN AND ALLIED HEALTH
APPLICATIONS
(in calendar days)
In addition to file processing indicators, TPQVO conducts routine
internal file audits and periodic external file audits. As part of file
processing, files are reviewed before distribution to clients to assure
quality on a prospective basis.
Performance Indicator: Client Satisfaction
As part of its Quality Improvement Program, TPQVO surveys
its clients each year on twelve dimensions of product and service
quality including timeliness, accuracy, communication and complaint
handling.
Since the survey’s inception in 1998, a majority of
clients responded to the survey and provided important feedback. The
chart below shows scores for 2009 and is representative of scores for
all years. Most clients report they are satisfied or very satisfied
with all quality dimensions and 100% of clients stated that would
recommend the service to others. Service dimensions tracked include
timeliness, accuracy and organization of appointment and reappointment
files, knowledge of the client and overall knowledge, communication and
responsiveness to questions and concerns. TPQVO followed up on concerns
noted in surveys and reviewed all comments and suggestions included in
the narrative section.
Another way TPQVO gathers feedback from clients is
through regular client meetings in the client’s service area. Clients
attend Client Meetings to discuss new products and services, improving
services, and other ways to make the working relationship with TPQVO
more successful. Client meetings are conducted twice a year.
Contracting and Delegation
Health care organizations delegate both the
responsibility and liability for credentials verification, including
National Practitioner Data Bank through a formal written contract for
services. NCQA CVO certification is maintained for the convenience of
managed care plan and network clients to simplify the credentialing
delegation process. TPQVO maintains professional and general business
liability insurance for the protection of its clients.
TPQVO provides reasonable access to its operations and
files by clients for auditing purposes. Staff is available to meet with
organization committees and officers on an as-needed basis.
Managed Care Credentials Verification
TPQVO is a NCQA certified Credentials Verification
Organization in 10 out of 10 credentialing services.
Allied Health Provider Credentialing
Allied Health Providers are defined as those health care
practitioners licensed or otherwise certified but are not included in
the definition of medical staff for hospital and health plan purposes.
Client References
Client references are available upon request.
For more information, please feel free to
contact us.
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