Primary Source Verification..

Are You...

A hospital looking to maximize your medical staff office personnel for privileging/ appointment/ reappointment?

A large practice looking for delegated credentialing?

Considering hiring a new physician or offering a partnership?

Then Primary Verification by AddVal is the answer. AddVal checks the validity of all physician information submitted. In accordance with Joint Commision, state and NCQA requirements, information is checked through database searches, correspondence to the appropriate organizations, queries, etc. Standard items verified on each physician application include:

State license(s)

DEA & CDS registrations

Clinical privileges at primary hospital

Board Certification(s)

Malpractice Coverage

Medical Education and Graduate Training

Medicare/Medicaid sanctions

National Practitioner Data Bank queries

Additional items (references, credit checks, criminal background checks, etc) are added at the client’s request.

You receive all original documents obtained by AddVal from the Primary Verification sources. After verification is completed, you will receive a summary profile on each physician for easy review by the Credentials Committee or hiring group.


Compliance / Coding Audits

Are You...

Looking for outside review of your billing and coding processes?

Concerned that your practice is meeting all HIPAA rules and regulations without compromising patient care and service?

Wanting a Compliance expert to relieve you and your staff of this burden?

AddVal uses ONLY experienced RNs to complete Medicare and HIPPA compliance reviews. We will review your existing processes and documents to identify any areas of improvement. In addition, we will audit a sampling of your claims to ensure your billing practices meet all requirements so that you can avoid outside audits, fraud accusations and more.

Data Collection & Site Visits

Are You...

A managed care company expanding into new geographical areas and need site visits done for credentialing your physician network? Let AddVal relieve your provider relations and quality improvement staff – we do the site visits for you! AddVal will:

Work with you to define the elements for data collection and/or audit.

Using the list of physician offices, hospitals, and/or clinics, AddVal schedules the visits and faxes a confirmation letter to the physician office. AddVal submits the data and results to you within the time frame needed.

Each site receives a satisfaction survey to determine level of performance.

Results of the site satisfaction survey are submitted to you twice a year.

AddVal’s advantages for you:

Experienced Registered Nurses complete the data collection, document reviews, and HEDIS and/or claims audits. Reliability and validity of collection processes are guaranteed. AddVal staff prepares all materials, schedule the visits and work with the offices to minimize any disruption to patient care activities.

Reliability & Validity are guaranteed. All AddVal Nurse Reviewers are required to maintain a 95% level of reliability and validity for all data collection and audit methodologies.

AddVal lowers your costs & saves time. Data collection & audits are scheduled, completed and returned to you in record time without duplication of visits.

Physician satisfaction is important. Each site receives a satisfaction survey for completion. The results are submitted to you twice a year or at the conclusion of the project – your choice. AddVal assures that the visits occur with minimal disruption to patient care.

 


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