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Provider credentialing is the recognition of professional and technical competence. This
process includes the gathering of detailed information on providers of care and the
selection of providers for participation based upon compliance with predefined standards.
With the advent of the Accreditation Association for Ambulatory Healthcare (AAAHC), The
Joint Commission, the National Committee for Quality Assurance (NCQA) and URAC and their
accreditation of healthcare organizations, credentialing standards were established and
the requirements for demonstrating competence were intensified.
The verification of credentials in the process of credentialing has been a business problem
in health care. Mailing and following up on requests for verification from the multiple
primary sources required can be a costly and labor-intensive administrative process, which
has left many managed care organizations, hospitals, ambulatory surgery centers, PHOs and
IPAs with hundreds of provider files in various states of completion.
CCA has developed an organized approach to this process that can minimize the cost and
decrease the turnaround time for provider credentialing. In addition to ensuring compliance
with AAAHC, The Joint Commission,NCQA, and URAC credentialing standards, our procedures are
geared for high degrees of timeliness, completeness and accuracy.
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