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TPQVO is NCQA Certified for
Another 2 Years
July 10, 2009
The Tennessee
Physicians’ Quality Verification Organization, LLC (TPQVO), a Chattanooga,
Tennessee based company, successfully
underwent its fourth Credentials Verification Organization (CVO) recertification
process through the National Committee for Quality Assurance (NCQA) and is fully
Certified by NCQA for 10 out of 10 verification services. This
two-year certification is effective until August 1, 2011.
The CVO
certification process involves two major survey components: (1) a review of the
CVO's operations, processes and programs and (2) an on-site audit of completed
credentials files to verify that the credentialing processes are conducted in a
manner that complies with NCQA's standards. “The credentials verification
process helps protect the public—making sure a patient’s doctor, nurse or
dentist has completed the education and training they purport to have and that
they are clear of any licensing or malpractice trouble" explained Pete
Kelley, MD, TPQVO Chairman and Chattanooga surgeon. "NCQA’s review of TPQVO shows that we are
performing this important verification process the right way and within the
right time frame.”
CVOs like TPQVO
contract with health care organizations, physician networks, and managed care
plans to provide information used to help determine whether physicians, dentists
and other healthcare providers are qualified for membership on that
organization’s staff or panel. Credentials verification is an important part of
safeguarding patients and plan enrollees by making sure healthcare providers
have the necessary training, licensure, experience and lack of negative
professional experience to provide safe and competent healthcare services.
CVOs also track disciplinary information released by state and federal agencies
and notify clients of any negative information that arises regarding their
healthcare professional medical staff and network members. NCQA evaluates a CVO’s
management of various aspects of its data collection, verification and
monitoring operations,
and the process it uses to continuously improve the services it provides to its
clients. “Achieving CVO certification from NCQA demonstrates that TPQVO has
the systems, process and personnel in place to thoroughly and accurately verify
providers’ credentials and help health plan clients meet their accreditation
goals,” summarized NCQA President Margaret E. O’Kane.
"NCQA is all
about quality and our continued designation attests to our commitment to our
clients that quality is our mission in the credentialing arena. Achieving
and maintaining this certification for the past 10 years gives value and comfort
to our clients and potential clients--they know our service product meets the
industry gold standard," adds Don Alexander, Tennessee Medical Association CEO. TPQVO CEO Sally Wencel notes, “even
though most of our clients are Joint Commission accredited, our undergoing this
intensive and expensive biennial review shows that we walk our talk when it
comes to quality.”
"TPQVO's
management and staff are to be congratulated for this accomplishment. As a
member of the Board of TPQVO, I am well aware of the professionalism, timeliness
and accuracy demonstrated in their work of credentialing physicians and allied
health professionals, and this recertification by an organization with very
exacting standards provides well deserved recognition of this," offered Mel
Twiest, MD, TPQVO Board member.
Started in 1998,
TPQVO is owned by the Chattanooga and Hamilton County Medical Society, the
Knoxville Academy of Medicine and the Tennessee Medical Association. Currently,
TPQVO maintains and monitors over 6,000 physician, nurse, dentist and other
healthcare practitioner files. Information in these files are verified and
processed for over 50 hospital, health care network, surgery center, public
health service, nursing home and home health clients through out the United
States.
The National
Committee for Quality Assurance is an independent, non-profit organization that
certifies credentials verification organizations, and accredits managed care
organizations. The NCQA certification process is voluntary and includes
rigorous on-site evaluations conducted by a team of health care professionals.
A national oversight committee of physicians analyzes the team’s finding and
determines certification based on the CVO’s compliance with NCQA standards.
CONTACT: Sally
Wencel, (423) 495-1191, Toll-free: (888) 779-0300
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TPQVO
Celebrates 10 Years
July 1, 2008 marks TPQVO's 10-year anniversary of
providing credentials verification and application
services. Back in 1998, the healthcare credentialing
landscape looked much different from today:
The American Medical Association's American
Medical Assessment Program (AMAP) was in full
development swing and proposed to offer physicians a way
to control their own credentialing portfolio.
Today, AMAP is gone, replaced in part by medical
specialty boards emphasis on "maintenance of
certification." Some specialty boards like the American
Board of Obstetrics & Gynecology now require
recertification on an annual basis!
Many surgery centers were using a physician's
affiliations with a local hospital as a proxy for
performing their own credentialing process. Most
surgeries were performed in hospitals.
In the past decade, the trend toward more outpatient
surgery continues. For the past five or so years,
surgery centers and physician offices performing surgery
must be accredited as part of state licensing and
perform independent credentials verification processes
as part of accreditation/licensing.
The National Practitioner Data Bank queries were
performed using a modem and DOS-based software called
QPRAC. The NPDB reports were then mailed to the
requestor.
Today, NPDB queries can only be performed through the
IQRS using highly secured and encrypted Internet
communication methods.
Getting a state license verification meant mailing
a letter of request or using roster that was published
periodically.
These days, most state licensing boards will only
provide verifications through web site portals. Many
state licensing boards require an annual subscription
and successful registration to obtain official
verifications.
License and other non-static credentials were
verified periodically during the recredentialing
process. Hospitals relied on the medical staff member to
notify them of any problem with licensing, liability or
about any loss of insurance coverage.
Since 2005, hospitals must monitor expiration dates
and obtain verifications on an ongoing basis.
Identity theft was unheard of and most credit card
theft was done by finding credit card receipts. There
was little reason to be concerned about using your
social security number for identification purposes. No
one had heard about any cases of physician imposters.
Today, even the public has heard about dangerous
imposters like Michael Swango who manage to get
appointed to hospital staffs and pose a real threat to
patient health. The reason for performing primary source
verification checks was to comply with JCAHO (now called
"Joint Commission") standards. "Negligent credentialing"
was rarely discussed or understood.
Now, healthcare organizations are more vigilant and
take credentials verification more seriously as an
important part of risk management. As a result of these
trends, credentials verification is more demanding than
ever.
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Higher technological investment in hardware and
software
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Continuous training in the various accrediting
organizations' credentialing standards
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Greater attention to processes, including
keeping current Policies & Procedures
TPQVO has keep current with these trends by making
the educational and infrastructure investment required
to meet or exceed credentials verification demands. It
makes more sense then ever to outsource credentials
verification to TPQVO.
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