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Credentialing 2022
What Solutions Have Fulfilled Their Efficiency Promise?

author - Niel Oscarson
Author
Niel Oscarson
author - Emily Paxman
Author
Emily Paxman
 
October 18, 2022 | Read Time: 6  minutes

Credentialing management has historically required dozens of spreadsheets, manual data entry, and painstaking monitoring of multiple payer, state, and national databases—causing significant inefficiencies and expenses. Vendors providing credentialing software and/or services promise major efficiency gains for healthcare organizations, but not all offerings are equally effective. This report examines three strong predictors of efficiency—the use of automations, strong credentialing workflows, and vendor partnership/guidance—to determine how well vendors are living up to their promises.

How Vendors Deliver Credentialing Offerings

While vendors have different approaches to credentialing or serve different segments of the market, they all share the same goal—to enable and support provider organizations’ credentialing processes. To the right is an overview of measured vendors’ offerings and customer bases.

offering types and customer landscape

ASM & Modio Health Reduce Turnaround Times, Consolidate Tracking; 
RLDatix’s Strong Automation & Services Drive Satisfaction

vendor impact on efficiency vs. drives tangible outcomesASM customers frequently report being fully paperless thanks to MD-Staff’s electronic application tools, virtual committee capabilities, and robust connections with outside databases. Strong functionality and automations have helped organizations decrease FTEs and significantly reduce turnaround times. Customers look forward to advancements like moving to the cloud and gaining the ability to manage volume and quality statistics. Some respondents note that challenges during implementation limit adoption. Modio Health primarily serves ambulatory groups, though KLAS has validated use of OneView in several small hospitals (less than 200 beds). The system helps customers eliminate the need for paper and spreadsheet tracking, and having a single source of truth saves staff time and reduces turnaround times. Respondents feel the vendor could provide better road-map communication and more prescriptive guidance. RLDatix (who acquired Verge Health in 2020) provides a combined model of software and services to help healthcare organizations manage credentialing tasks. While customers aren’t responsible for the entire credentialing process, they still heavily use and benefit from RLDatix’s front-end automations for credentialing panels and renewal notifications. Respondents highlight weekly meetings between their credentialing offices and the vendor’s personnel that provide opportunities to discuss any missing items, challenges, and best practices.

Industry-Wide, Workflows Need Improvement; 
Customers of symplr & VerityStream 
(Limited Data) Struggle Most Due to Poor Training

satisfaction with ability to configure efficient workflowsAll measured vendors are rated somewhat low for their ability to configure workflows that drive efficiency. symplr and VerityStream customers most frequently report workflow struggles. Dissatisfied symplr customers using the vendor’s legacy solution feel they didn’t get the training needed to be successful; they also feel manuals and other resource materials aren’t as helpful as they could be. As a result, users sometimes work around solution functionality rather than configuring workflows to meet their needs. Organizations that have seen success with workflows mention using symplr’s support line to ask questions and improve their use of the system, and they generally view the solution as easy to use and able to meet base needs. symplr's go-forward solution, symplr Provider, has yet to be rated by KLAS and is part of a larger portfolio targeting healthcare operations. VerityStream CredentialStream is the go-forward solution intended to replace Echo Solutions and MSOW, and many new CredentialStream customers are still in the process of reconfiguring their workflows. While this process is difficult, customers appreciate the solution’s customizability in comparison to that of older VerityStream solutions. Still, users have struggled to reach an optimal state with CredentialStream because of its complexity and insufficient training.

Silversheet (Limited Data) Struggles to Eliminate Manual Work for Customers; 
New VerityStream 
(Limited Data) Platform Requires Significant Work to Build Useful Automations

satisfaction with automations’ impact on efficiencyDue to experiences with errors in the software, Silversheet customers have limited trust in their system. Credentialing offices that use Silversheet must spend time manually verifying information, and when issues are raised, the vendor’s communication and problem resolution are slow. However, a few respondents say they now have a dedicated account representative and hope for an improved support experience in the future. Other areas of improvement for Silversheet include reporting limitations, manual data entry, and poor tracking. Early feedback from VerityStream customers who have moved to the new CredentialStream solution indicates that it is significantly more user friendly and functional than the vendor’s older solutions. However, as previously mentioned, these customers also note CredentialStream is complex and requires more work to implement and learn than expected. Although the support experience has been more positive, a lack of guidance and training has caused customers to feel they are on their own when building automations that eliminate work and drive value.

Document Autofill, Virtual Committee & License Verification Automations Drive Most Satisfaction

Regardless of vendor, customer respondents who report using automations for document filling, virtual committees, and license verification are significantly more likely to report positive outcomes and say their vendor has improved their efficiency. Automations with room for improvement are also generally consistent across vendors; state-license verification, entity cloning, and status tracking are common pain points.

automations–strengths and areas for improvement

Modio Health & RLDatix (Limited Data) Stand Out with Strong Guidance; 
QGenda 
(Limited Data) Also Shows Promise

satisfaction with vendor guidance on driving efficiencyModio Health customers highlight their vendor’s ongoing education program, Modio University, which enables users to share best practices with each other and stay knowledgeable about the product as it evolves. RLDatix customers have opportunities to receive guidance through their regular meetings with account representatives, who are noted for their deep understanding of organizations’ processes, goals, and policies. However, turnover among the vendor’s staff has affected the consistency of the support experience. In 2021, QGenda acquired CredentialGenie, a solution primarily focused on the ambulatory market; post-acquisition, the customer experience has remained the same or, in some cases, improved. Customers of this solution report positive experiences thanks to strong implementations that set them up for long-term success, and they also benefit from proactively shared best practices from the vendor.


About This Report

Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. KLAS’ standard quantitative evaluations for healthcare software and services are composed of numeric ratings questions and yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into six customer experience pillars for software (culture, loyalty, operations, product, relationship, and value) and five pillars for services (loyalty, operations, relationship, services, and value). These standard ratings are available on the KLAS website.

For this study, KLAS created a supplemental evaluation to understand how vendors perform in several areas that are key to the credentialing market. KLAS asked interviewed participants about several areas highly connected to increasing efficiency (the main outcome expected), including solution features aimed at efficiency improvement, their vendor’s ability to provide guidance and best practices, and the strengths and weaknesses in their solution’s various automations. The data was collected over the last 12 months.

about this report table

Sample Sizes

Sample sizes displayed throughout this report (e.g., n=16) represent the total number of unique customer organizations interviewed for a given vendor or solution. However, it should be noted that to allow for the representation of differing perspectives within any one customer organization, samples may include surveys from different individuals at the same organization. The table below shows the total number of unique organizations interviewed for each vendor or solution as well as the total number of individual respondents.

Some respondents choose not to answer particular questions, meaning the sample size for any given vendor or solution can change from question to question. When the number of unique organization responses for a particular question is less than 15, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 6, no score is shown. Note that when a vendor has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.

Product Designations Used in This Report

  • Mostly ambulatory [A]: Product for which the majority of respondents are associated with ambulatory care
  • Primarily services: Offering based mainly in professional services (rather than software alone)
author - Natalie Hopkins
Writer
Natalie Hopkins
author - Jessica Bonnett
Designer
Jessica Bonnett
author - Ethan Lui
Project Manager
Ethan Lui
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.

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