Services....

Click on a service below for more information.

  • Managed Care (NCQA / URAC) Level Credentialing
    • Managed Care (NCQA/URAC) Level Credentialing

       

      GDS provides primary source verification services for credentialing and recredentialing files to meet NCQA / URACstandards, or our verification packages can be customized to meet Client specific requirements. Our average turn-around time on Managed Care credentialing is approximately 25 days.

      Our NCQA / URAC level primary source verification service may include the following verifications, but can also be customized:

      bullet DEA License / Primary State License
      bullet DEA License / State Drug Certificate
      bullet Malpractice Insurance Certificate
      bullet Primary Hospital Affiliation
      bullet Board Certification
      bullet Education & Post-graduate Training
      bullet NPDB / HIPDB Query
      bullet Malpractice Claims History
      bullet License Sanctions

      GDS utilizes the most up-to-date primary sources available, including online verifications acceptable to all accrediting / certifying agencies, and we hold accounts with major primary verification agencies to speed the process of credentialing (ABMS, AMA, AOA, etc.)

  • The Joint Commission / AAAHC Level Credentialing
    • The Joint Commission / AAAHC Level Credentialing

       

      GDS provides primary source verification services for initial appointment and reappointment files to meet TJC / AAAHCstandards, or our verification packages can be customized to meet Client specific requirements. Our average turn-around time on TJC/AAAHC files is approximately 45 days.

      Our Joint Commission / AAAHC level primary source verification service may include the following verifications, but can also be customized:

      bullet All current/past State Licenses
      bullet DEA License / State Drug Certificate
      bullet Malpractice Insurance Certificate
      bullet All current/past Hospital Affiliations
      bullet Board Certification
      bullet Education & Post-graduate training
      bullet ECFMG, if applicable
      bullet NPDB / HIPDB Query
      bullet FSMB
      bullet Malpractice Claims History
      bullet License Sanctions
      bullet Medicare Sanctions
      bullet Employment / Work History
      bullet Peer References
      bullet CME Collection
      bullet TB Test Collection
      bullet Privilege Form Collection
      bullet Application & Attestation review

      GDS utilizes the most up-to-date primary sources available, including online verifications acceptable to all accrediting / certifying agencies, and we hold accounts with major primary verification agencies to speed the process of credentialing (ABMS, AMA, AOA, etc.)

  • Expirables Maintenance
    • Expirables Maintenance

       

      GDS provides an Expirables Maintenance service, which ensures providers non-static credentials are kept current. These non-static credentials may include:

      bullet Primary State License
      bullet DEA Certificate
      bullet State Drug Certificate
      bullet Fluoroscopy / Radiography Certificate
      bullet Malpractice Insurance Certificate
      bullet Board Certification

      GDS utilizes primary sources to obtain the verifications of renewed or updated credentials prior to their expiration. These primary sources may include:

      bullet State License Boards
      bullet NTIS
      bullet ABMS, AOA, and other Specialty Boards
      bullet Direct requests to the provider

      Clients receive a set of weekly reports from GDS noting 1) those non-static credentials which have been updated and are available for download via our web access, iObserver, and 2) those non-static credentials that remain expired.

      GDS will continue to query primary sources and contact the provider, as necessary, to ensure successful updating of the “Expirable” verification.

  • Ongoing Sanction Monitoring
    • Ongoing Sanction Monitoring

       

      GDS provides an Ongoing Sanction Monitoring service to immediately alert our Clients of a provider identified on any of the various Sanction reports GDS receives, which are listed below. Following a detailed cross checked against the clients providers located within the GDS database, the client is notified within 48 hours of any possible provider match. These reports may include:

      bullet State License Board Disciplinary Reports, as released
      bullet Office of the Inspector General (OIG) Sanction Exclusion
      & Reinstatement Report, monthly
      bullet Excluded Parties List System (EPLS)

      GDS will also provide the client with a Month End Sanction Summary Report, which will list all actions, discovered during the month ending, or will note “No Sanctions Discovered”.

  • Consulting
    • Consulting

       

      GDS offers an array of consulting services to assist hospitals, surgery centers, health plans, medical groups and other various entities with a variety of credentialing needs. Consulting may range from the start-up of a credentialing program to the preparation for Survey. Service Packages offered include:

      Starting from Scratch – Building a Credentialing Program

      bullet Setting up Policies & Procedures
      bullet Defining processes & work flows
      bullet Structuring credentialing committees
      bullet Developing forms, letters, and applications
      bullet Training Staff
      bullet Setting

      Time for a Refresher – Assessing Your Current Credentialing Program

      bullet Review of Policies & Procedures
      bullet Review of forms, letters and applications
      bullet Overview of primary sources utilized during the
      verification process
      bullet Overview and assessment of current process work flows
      to improve efficiency
      bullet Audit of credentialing files
      bullet Review of current credentialing software to maximize benefits
      bullet Refresh & Retraining of staff
      bullet Detailed written summation of findings
      bullet Recommendations & Suggestions for improvements

      Help! We are preparing for Survey!!!

      bullet Review of Policies & Procedures – are you doing what you say you
      do?
      bullet Review of forms, letters and applications – are you compliant
      with the standards?
      bullet Overview and assessment of current process work flows
      bullet Audit of credentialing files
      bullet Review of Quality program
      bullet Preparation of materials required for auditor review
      bullet Mock interviews with staff
      bullet Detailed written summation of findings
      bullet Recommendations & Suggestions for improvement to be
      implemented prior to survey
      bullet Assistance with implementing and on-site survey

      Centralize Us! For multi-hospital or group systems wishing to Centralize

      bullet Detailed Assessment of current processes in place at each facility
      bullet Review of each facilities policies, processes, forms, applications,
      reports and databases
      bullet Recommendation on process for internally centralizing amongst
      system facilities
      bullet Development of a detailed plan for implementation
      bullet Assistance with implementing the centralization plan

  • Application Management
    • Application Management

       

      GDS offers the service of preparing and sending out applications to providers on behalf of our Clients at both Initial Credentialing and Recredentialing.

      At Initial Credentialing, GDS will prepare the application packet to be mailed/faxed/emailed directly to the provider. GDS will include any Client specific documents required (i.e. addendums, privilege forms, etc.), track the application send date within the GDS database, and provide 2nd and 3rd follow-up requests as needed. Upon receipt of the application, GDS will begin processing the primary source verifications.

      At Recredentialing / Reappointment, GDS will prepare the application packet by pre-populating information into the application directly from the GDS database, lessening the amount of application work for your providers. We will include any Client specific documents required (i.e. addendums, privilege forms, etc.); track the application send date within the GDS database, and provide 2nd and 3rd follow-up requests as needed via phone, fax or email. Clients are kept in the loop of requests made as well as non-responding providers by our providing a weekly ‘Recredentialing Follow-Up Report” which includes details of follow-up dates and notes regarding specific provider correspondence. Upon direct receipt of the application, GDS will begin processing the primary source verifications.

      As an added benefit to our Recredentialing service, we can enter and track in our system, your provider’s on-going committee approval dates in order to oversee your overall recredentialing schedule. This allows us on a monthly basis, to run reports to identify those Provider’s coming due for recredntialing (“Recredentialing Due Reports”), email these reports to you and upon your review and approval, we will then send out the pre-populated recredentialing applications to those providers listed on the reports. This assists you with oversight of your recredentialing schedule to ensure files are processed prior to their next recredentialing due date.

  • Fast-Track Service
    • Fast-Track (RUSH) Service

       

      GDS offers a means of expediting credentialing files quickly, beneficial when Clients must receive a providers credentialing file in less time than our regular service provides. Our Fast-Track service offers the following turn-around times:

      Managed Care Level Files – 12-day
      TJC / AAAHC Files – 25-day

      To expedite the processing of credentialing files, AMA profiles may be utilized for the verification of Education & Post-Graduate training, and telephonic verifications may be required in order to obtain additional verifications.

  • Data Exchange Service
    • Data Exchange Service

       

      Manual data entry can put a strain on staff time, hinder productivity and can ultimately be costly. Imagine having your credentialing data, daily changes, and new provider information automatically updated in your system on a regularly scheduled basis.

      We offer the ability to extract data from the GDS database and automatically relay it to our Clients in various formats to be imported into your system. We can customize the export to capture any necessary fields or file layout mandates that you may require as well as tailor it to a schedule that works best for your organization (nightly, weekly, etc.).