Credentialing & Quality Management

The VIPsystem offers superior credentialing functionality. Credentialing is a key aspect of overall provider data management, medical staff management and the overall workflow design of provider processing in the VIPsystem.
The VIPsystem offers sophisticated ticklers, expiration reporting and mass processes that ensure verifications are completed in accordance with the national healthcare commissions. The VIPsystem truly simplifies many of the tasks and requirements set forth by the TJC, NCQA, URAC and CMS. Each screen in the VIPsystem has unlimited notes, unlimited images and unlimited data lines. A client is never forced to drop history or data because there are not enough fields to accommodate the information. All data elements and documentation required are easily maintained. The following details the type of information that can be tracked in compliance with industry standards.
- Provider Demographics
- Certifications-ABMS, AOA and Others
- Liability Insurance-Current and History
- Provider Competence-Affiliations
- Provider Education and Training
- License Information
- Expiration of all Licenses, Insurance, Boards and Sanctions
- References
- Sanction and NPDB Queries/Tracking
- OIG
- Work History
- Renewal Process
- Attestation and Verification Cycle Dates
- Quality Assurance, Utilization Data and Peer Review
- Performance Tracking, FPPE, OPPE
- Full Audit Logs for Changes to Provider Records
- Status History
- Personal Data including: Physicals, Contact information, Alias, etc.
- Group and Individual Practice Information
- Automated Credentials Committee Management
- Continuing Medical Education
- Coverage Partners and Allied Health Provider Detail
- Committee Assignment/Attendance
- Quality Improvement Data: AMR's, Patient Satisfaction, Performance, etc.
The VIPsystem can track many important non-regulatory elements as well, including:
- Fees and Dues
- Provider Products or Plans with Fee Detail
- Office Hours
- Entity or Contractual Relationships
- Pending Problems
- ER Call
- Departments
Hospital Privileges

The VIPsystem allows hospitals to manage delineated clinical privileges and provide internal online access for quick verification by clinical staff via our e-Privileges module. VIPsystem functionality allows hospitals to establish facility specific or multi-entity appropriate master table of privileges with detailed procedures and/or core descriptions. Delineated privileges are assigned to individual providers by department (service) and privilege type. Automating the management of clinical privileges promotes simple application and renewal processing and ensures compliance with CMS and standards regulations.
The VIPsystem allows each client to design their privileges based on core or the traditional laundry list method, or a combination of both.
Quality Management

Special consideration was given to Quality management tools to simplify the collection and analysis of practitioner performance information making compliance with OPPE and FPPE standards seamless. We provide tools that manage the Peer Review process, updates from clinical systems for fundamental quality indicators and performance data, chart and site review tools, corrective action plan management, patient and practitioner satisfaction tracking tools and unlimited possibilities for quality improvement measurement. Each client can configure the quality measures appropriate to the services provided by their organization in accordance with TJC and CMS standards.
Managed Care tools include chart, site, and HEDIS surveys.



