Synergy - July/August 2014 - 20

BANK ON IT

Authorized Agents Can
Help Save You Time with
Credentialing
By Donald Illich

I
Donald Illich is a writer-editor for
the Division of Practitioner Data
Banks, which is part of the Health
Resources and Services
Administration, Bureau of Health
Professions. He has written
several articles for both internal
and external audiences
concerning the policies and
operations of the Data Bank. He
is a member of the Division's
Policy and Disputes Branch. He
lives and works in Rockville, Md.

f you are a medical staff professional for a
hospital, then you realize your hospital
must query the National Practitioner Data
Bank (NPDB) when a practitioner applies for
a staff appointment or clinical privileges and
every two years thereafter for practitioners
on staff or who hold privileges. If your
credentialing office handles a large volume
of applicants and is responsible for
re-credentialing hundreds of practitioners,
this may prove overwhelming. For this
reason, your office could benefit from using
an authorized agent, especially if you must
credential for a large health network. An
authorized agent is generally a credentialing
verification organization (CVO) that devotes
its time solely to verifying information
contained in applications for appointments
to staff or for clinical privileges. It is common
for hospitals to use agents; about 37 percent
of hospitals registered with the NPDB do so.

Note that when using agents, hospitals and
other healthcare entities still bear the ultimate
responsibility for making sure reports and
queries are submitted to the NPDB at the
right time for its practitioners. Thus, hospitals
must closely monitor their authorized
agents. Despite this, using an agent can be
cost-effective and can increase efficiency.
Before your hospital can designate an agent
to act on its behalf, you must ensure that
your hospital or healthcare organization is
registered as a healthcare organization with
the NPDB and that the authorized agent is
also registered with the NPDB.
Healthcare entities and their authorized
agents complete separate registration
forms that can be accessed from the
NPDB website. Once registered, the
healthcare entity must designate the agent
by completing an online Authorized Agent
Designation form through the Data Bank's
secure website. This must occur before the
authorized agent is able to submit queries
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on behalf of the entity. The initiating entity
must indicate whether it wishes to receive
query responses, wants its agent to receive
its query responses, or would like the query
responses sent to both the healthcare entity
and its agent. The NPDB can accommodate
multiple authorized agents for each entity.
A healthcare entity that has designated
an authorized agent can still query and/or
report to the Data Bank directly. Responses
to queries or reports submitted by the
initiating healthcare entity will be returned
to the initiating entity, regardless of routing
designation.
The NPDB prohibits an authorized agent from
redelegating some or all of its responsibilities
to another authorized agent. The eligible
entity must have a direct relationship with
its authorized agent. The following are a few
other items you should take into account
when designating an agent.

1. The agent must have a DBID.
Since confidential Data Bank information
may be routed to authorized agents that
are required to maintain confidentiality
in accordance with regulatory
requirements, agents are assigned a Data
Bank Identification Number (DBID).
An authorized agent should have only
one DBID, even though more than one
healthcare entity may designate that agent
to query or report to the Data Bank. If an
authorized agent has been issued more than
one DBID, the agent should immediately
alert the Data Bank, identify which DBID
will be used, and request that any other
DBIDs be deactivated.

2. The agent and healthcare entity
must maintain confidentiality through
a written agreement.
As part of reporting and querying
requirements, healthcare entities are
http://www.npdb.hrsa.gov/hcorg/register.jsp http://www.npdb.hrsa.gov/hcorg/register.jsp http://www.npdb.hrsa.gov/hcorg/howToDesignateAnAuthorizedAgent.jsp http://www.npdb.hrsa.gov/hcorg/howToDesignateAnAuthorizedAgent.jsp
Synergy - July/August 2014

Table of Contents for the Digital Edition of Synergy - July/August 2014
