|VerifPoint evolved from the nationally recognized credentialing
company CreDENTALs. Founded in early 1996, CreDENTALs became the largest dental credentialing verification organization
in the world. Due to the administrative cost constraints in the dental benefits industry (compared to those in medicine),
CreDENTALs created an efficient, automated system of credentialing. Having dominated the dental credentialing market,
CreDENTALs, now VerifPoint, began leveraging its credentialing system and expertise into all areas of healthcare practitioner
verification and data/image management.
What We Do
Verifpoint is a healthcare services company that upholds the highest level of quality care when
credentialing healthcare providers. We offer a nationwide network and knowledgeable staff to our consumers
and business partners. Through Verifpoint and our subsidiaries, we engage in the following business activities:
Verifpoint/ CreDENTALs Services aims to deliver exceptional customer-driven products and services by
letting the customer decide how and where they want to do business with us. We are fully certified by
the National Committee for Quality Assurance until October 5, 2007. Using guidelines set by the NCQA,our credentialing reports provide up-to-date information on a provider with 11 key elements:
• License to Practice
• Hospital privileges
• DEA/CDS Registration
• Board Certification / Residency Completion / Medical School
• Malpractice Insurance
• Malpractice Claims History
• Application Processing
• NPDB/ HIPDB
• Medicare/Medicaid Sanctions
• Sanctions Against Licensure
With over 3 quarters of a million practitioners' information in our database, we are able to generate
practitioner credentialing reports twice a month. In addition, several network management reports are
created to keep you constantly aware of the status of all your providers in your network.
One of our greatest technology strengths to our clients is our delivery of all practitioner documents as
optically scanned electronic images (along with the credentialing reports). This standard feature of our
verification services, eliminates countless file cabinets and tedious paper storage / retrieval.
All practitioner data and supporting documents are available 24/7 via our secure websites.
Special Application Processing :
VerifPoint will mail, scan and process specialized provider applications such as your in-house 20-page
application or a state mandated application (i.e. the State of Maryland’s Universal Application Form).
EDI and Custom :
VerifPoint is pleased to offer fully customizable verification and data storage / transfer services based on
your specific needs.
Continuous Credentialing Service:
As an added service or a stand-alone solution, a constant updating of provider credentials is provided,
from the VerifPoint database, for the following data elements:
- License to Practice Sanctions
- Other Drug Certificates (CDS, TPA, DPA, etc.)
- Professional Liability Insurance
This service was made available due to VerifPoint’s constantly updated database and the requirements
by various state agencies.
For example, the following statement was received from a California Department of Managed Care
reviewer by one of our Health Plan clients during their recent audit report:
“It is clear that the contracted CVO Service through CreDENTALs / VerifPoint, provides the
necessary patient protections and demonstrates that the Plan has implemented a
re-credentialing tickler system that is tied to license expiration data; and that these
re-credentialing efforts are current such that no provider for the Plan is treating Plan enrollees
when the Plan does not have evidence that demonstrates the Provider has a current license
and other current credentialing information. This CVO service is an excellent example of a
Health Plan meeting and exceeding DOMC goals and guidelines. ”
Online Application Service
Provides a simple, economical solution to filling out paper applications for Managed Care / Insurance
Carrier Plans. Our internet technology enables LastAPP users to create a complete professional profile
using ONE online form to populate numerous applications in minutes.
LastAPP is designed to be used for
most fields of healthcare. We currently offer chiropractic, dental, medical and vision
The online form contains the following data elements:
- Malpractice Claims History
- Specialty Information
- Hospital Privileges
- Work History
Instant Credentialing Report Service:
The QuickCheck service clearly exemplifies the size and sophistication of CreDENTALs database. Simply
by accessing the Internet, the CreDENTALs client can quickly, easily, and confidentially ascertain a basic
credentialing profile for any dentist in the country. Each CreDENTALs' client is given a confidential
password and account I.D. This will allow client dental plans, Dental IPAs, or dental service
organizations electronic Internet access into CreDENTALs’ database.
The information is instantly available and can be simply viewed or printed by the CreDENTALs client. Contained in this dentist profile are the following:
- State Licensing Status
- Verification of DEA license (when applicable)
- Board of Dental Examiners Report with any derogatories
- Medicare and Medicaid Sanctions
This service has numerous applications, some of which are listed below:
- A background check of a prospective dentist prior to hire or contracting by a dental plan,
- A single, convenient source for primary source verification – specifically for those plans or dental service organizations that wish to keep the provider credentialing task in-house,
- A streamlined credentialing process for those dental organizations that are not impacted by stringent NCQA* or other regulatory credentialing standards,
- A spot-check of any dentist to assure that the doctor’s credentials have not changed since the last credentialing report.