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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.
TPQVO is an NCQA CVO certified credentials verification organization
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
2008 Board of Governors:
Donald
Alexander, Secretary, Tennessee Medical Association
John Neff, MD, Knoxville Academy of Medicine
Mel Twiest, MD, Chattanooga and Hamilton County Medical Society
Charles Handorf, MD, Tennessee Medical Association
Rae Bond, Chattanooga and Hamilton County Medical Society
TPQVO is owned by two Tennessee metropolitan
county medical societies—Knoxville and Chattanooga--and
the Tennessee Medical Association. The
TPQVO Board of Governors is elected by its owner-members to govern the company.
Credentials
Verification Standards
TPQVO follows the credentials verification standards set by
the National Committee on Quality Assurance (NCQA) for managed care
organizations and the Joint Commission on Accreditation of Healthcare
Organizations for hospitals and surgery centers.
Some hospitals define higher credentials verification standards through
medical staff bylaws than those required by Joint Commission.
TPQVO will work with those institutions to meet those higher standards
whenever possible.
In addition to application processing and primary source
verification, TPQVO monitors expiring documents and licenses (DEA, insurance
certificates, 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 Tennessee licensing boards 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
2006 show few verifications exceeded TPQVO’s benchmark of 90 days for
appointments and 60 days for reappointments.
NCQA Credentials Verification Organization standards require
verifications be process within 120 days of an application’s signature
date.
File processing timeliness data were
reviewed for 2007 and summary charts are
available by clicking here. During
2007, TPQVO processed around 700 unique physicians and
400 allied health practitioners for initial credentialing and 1,500
physicians and 500 allied health practitioners for recredentialing.
Average processing times were 39 days for
physician initial appointment, 35 days for physician recredentialing, 51
days for allied health initial appointment, and 37 days for allied
health recredentialing. (Days are stated in calendar days, not business
days.)
These data include
files processed for all clients including clients requiring Joint
Commission, AAAHC,
and NCQA credentialing standards and both physician and allied health
practitioner classifications. Most files processed using NCQA standards are completed within 1
business day of TPQVO’s receipt of the completed application.
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 verification 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.
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.
As in past years, the majority of clients responding expressed they were
satisfied or highly satisfied with TPQVO services. (Click
here for a chart showing 2007
survey scores.) More
importantly, clients who responded to the to the question "would you
recommend this service to others" answered "yes." 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.
TPQVO is certified by NCQA in 10 out of 10
credentialing services.
Another way TPQVO gathers feedback from clients is
through regular client meetings.
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.
Managed Care Credentials Verification
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.
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.
For more information, please feel free to
contact us. |
