Credentials Verification Organization

RT Welter’s URAC accredited CVO provides initial and ongoing credentialing services, including primary source verification for:

  • Managed care organizations
  • Hospitals
  • Ambulatory surgery centers
  • IPA’s
  • PHO’s
  • Managed behavioral healthcare organizations
  • And other healthcare organizations

Our diligence, customer service & personal touch to credentialing gives our clients the experience they are looking for!Our URAC CVO accreditation ensures that our organization demonstrates the highest industry standards when examining and verifying a provider’s credentials to join a health plan or other healthcare network.  It also ensures that we are committed to make significant and ongoing investments in compliance, HR and IT security. Our credentialing experts, efficient operations, customer service and outreach activities reduces frustrations, burdens and delays for providers, health plans and other provider organizations during the credentialing process, while maintaining the standards of URAC.

Partnering with our CVO services you will experience a faster turnaround time for provider credentialing and re-credentialing and at a lower cost! Our diligence, customer service and personal touch to credentialing gives our clients the experience they are looking for!

Development of a Credentialing Program
RT Welter can assist with network development, the development of credentialing policies and procedures, provider applications, provider education materials regarding the credentialing process, overall process creation and structure, and other materials needed for compliance with URAC standards.

Approval, Oversight and Monitoring of Delegated Credentialing Organizations
RT Welter can assist managed care organizations and other large provider organizations with delegated program development and responsibilities of delegation.

Primary Source Verification
RT Welter offers comprehensive primary source verification services in accordance with URAC standards.

  • Current state license
  • Clinical hospital privileges
  • DEA and CDS registration (as applicable)
  • Malpractice insurance coverage and claims history
  • Board certification
  • Medical school and residency
  • Medicare/Medicaid sanctions
  • State license sanctions query
  • Work history
  • NPDB query (if requested)

Credentialing and Re-Credentialing Services
In addition to primary source verification, we also provide the following services as part of the credentialing process:

  • Active outreach to assist providers with an initial application or CAQH development and/or updates
  • Application review for required attached documentation
  • Review of the application and curriculum vitae for gaps in the provider’s work history
  • Outreach to providers to obtain missing or incomplete information
  • Document and communicate discrepancies that may prevent the provider from being credentialed
  • Medical Director on staff to approve and/or deny files
  • Maintain provider documentation such as state medical license(s), DEA, malpractice coverage, and board certification to maintain efficiency for the re-credentialing process

Ongoing Monitoring of Sanctions
To comply with URAC standards and requirements, RT Welter provides monthly, ongoing monitoring of the following types of information, and reports it directly to our clients on a monthly basis:

  • Sanctions or limitations on licensure
  • Medicare and Medicaid sanctions

Reporting
RT Welter provides its clients with monthly reporting including sanctions reports and credentialing/re-credentialing application status reports.  We can support virtually any reporting requirement our clients have.