ALEXANDRIA, Va., Oct. 19, 2017 /PRNewswire/ -- The health care industry is a technological laggard when it comes to identity authentication and verification of practitioner credentials. Many U.S. hospitals continue to use paper records to collect data for hiring and credentialing physicians even though a paper record is the easiest form of data to forge. And, for those entities employing spreadsheets or client-server data repository software, data input errors are frequent and extended delays to completion persist. Worse, though, data becomes static, hard to access and stale.
Approximately 190,000 of all licensed providers are, at any given time, practicing without an active license. State and Federal agencies are publishing updates on licenses, disciplinary status, exclusions, debarments and other changes in licensure or registration on a daily basis. Paper files in filing cabinets cannot track, monitor, report or capture this activity effectively, which means patients and health care organizations are at severe risk.
"Defrauding and abusing the health care system drives up costs and endangers patients. Eliminating fraud would be a giant step toward achieving affordable health care," says John Benson, Verisys CEO and Co-founder. "It would require massive changes to existing flawed systems and processes. We need to have an honest discussion about fraud prevention. Verisys delivers a solid gatekeeping and monitoring strategy in the commercial sector today, with data and solutions like CheckMedic and the MedPass. We need to stop spending money on magic bullets and start applying common sense solutions."
Patient safety is at the forefront of CheckMedic® by Verisys, the organization's newest iteration, end-to-end health care credentialing and compliance platform driven by the only fully aggregated primary source provider credentials data set in the market. Verisys has the most extensive and complete provider profile in the industry, more than 25 years in the making.
CheckMedic centralizes critical workforce data, creating a single source of truth and providing an unprecedented level of instant-access transparency. This degree of transparency is key to patient safety and satisfies the complex regulatory requirements for compliance to multiple standards. CheckMedic exceeds federal guidelines set by the OIG, state regulatory requirements, and certification and accreditation bodies including HFAP, DNV, NCQA, URAC and The Joint Commission.
Hospitals, pharmacies and health care institutions struggle with the administrative burden of onboarding practitioners across various departments including Human Resources, Medical Staff Services, Medical Affairs, Risk and Compliance, and Legal. Millions of dollars are spent on antiquated and isolated software programs, disparate and often unverified data sources resulting in 90+ day onboarding and enrollment delays, inaccurate data records and lapses in response to adverse actions. Compound that with static and stale data and you have a compliance nightmare.
The CheckMedic platform issues a digital MedPass® for each staff member and serves as the only application activity required of a candidate. The MedPass profile is auto-populated with Verisys' pre-verified primary source data and completed online, is housed in the cloud, and indicates full compliance for employment and credentialing to applicable standards and business rules.
The MedPass becomes a dynamic profile that is updated in real time and continuously monitored against up to 5,000 primary source publications including Verisys' proprietary data set, Fraud Abuse Control Information System (FACIS®), its National Abuse Registry, National Professional Licensure, DEA Registrant, State Controlled Substance, NPI, OFAC+, SSA-DMF, National Sex Offender, and Address Watch. FACIS® contains 8 million records and makes available both historical and current exclusion, debarment, disciplinary action and sanction records on the full health care taxonomy across every jurisdiction.
Static data, such as prior education, employment and authenticated demographic data, is locked following primary source verification so no one can alter the data or revise history. A notification system for license expiration, required continuing education, immunizations, and adverse actions are customized to each profile.
Through its advanced algorithmic approaches to name and record matching, Verisys has created proprietary identity resolution tools achieving 99.9% accuracy ensuring true identity for each issued MedPass.
Verisys has a dedicated, loyal and talented operations and engineering team that utilizes Agile methodologies, including Scrum implementation elements, to ensure it is poised to build sustainable solutions with the flexibility and adaptability necessary to stay ahead of the evolving health care landscape. Security measures are layered into every step of software development as well as the transfer and storage of data in a Tier 3+ environment that is regularly audited by an internal security officer as well as by authorized third parties on behalf of its Fortune 500 client base.
The Verisys team handles millions of transactions annually across the health care sector for some of the world's largest health care providers. Its clients include hospital systems, clinics, labs, pharmacies, pharmaceutical manufacturers, independent provider groups, dental and chiropractic practices, medical equipment manufacturers (DME), payers, managed care organizations, medical malpractice carriers, background screening companies, and credentialing organizations.
Verisys provides a comprehensive technology platform of data, analytics and services catering to the full spectrum of organizations in the health care sector. Verisys' mission is to protect health care consumers by enforcing competency and patient safety through transparency. As stewards of provider data, Verisys is one of only a few Credential Verification Organizations both URAC accredited and NCQA certified for 10 out of 10 verification services. Verisys is dedicated to mitigating legal, financial, and regulatory risk for its clients and their end-users by preventing fraud, waste, and abuse in health care. Verisys returns accurate and timely data on individuals, professionals, and businesses for contracting, privileging, employment, reimbursement, and referral validation purposes.
CheckMedic® by Verisys, is an integrated workflow, compliance, credentialing and monitoring solution that ensures all individuals and entities are properly licensed, certified, registered, fully compliant, and meet regulatory best-practices criteria. This end-to-end, cloud-based SaaS tool increases productivity, lowers costs, reduces administrative burden, and elevates accuracy.
ProviderCheck® by Verisys is a transactional prescriber and provider verification and monitoring solution. It checks pass/fail criteria at the time of dispensing or reimbursement for transparent processing that eliminates non-reimbursable events, loss of inventory, loss of revenue, and potential abuse and fines. ProviderCheck is one of the most effective transactional tools to expose bad actors at the heart of the opioid abuse crisis.
Earlier this year, Verisys was acquired by Spectrum Equity, with co-investments from Verisys CEO John Benson and Cressey & Company.
SOURCE Verisys Corporation