Your Credentialing Partner

 

TPQVO, LLC Credentials Verification Services

About TPQVO


TPQVO is located in Chattanooga, Tennessee, where it has provided credentialing services since July of 1998.  TPQVO was created as a limited liability company that merged the Chattanooga and Hamilton County Medical Society's and the Knoxville Academy of Medicine's Central Verification Services.  Those services began operations in 1991 and 1995 respectively, making TPQVO one of the oldest credentials verification organizations in the business. 

TPQVO is an NCQA certified credentials verification organization (CVO) that provides credentials verification services to hospitals, ambulatory surgery centers, health plans, networks and other healthcare organizations.  TPQVO provides application processing and credentials verification for medical staffs defined as medical doctors (MD, DO), podiatrists (DPM), dentists (DDS, DMD) and clinical psychologists (PhD) and allied health practitioners.  Allied health practitioners are defined as licensed independent practitioners or licensed healthcare practitioners who practice under the supervision of a physician or dentist.

Our clients include hospitals, healthcare networks, IPAs, surgery centers, physician offices, and local and state government departments throughout the country.

TPQVO Ownership

TPQVO is owned by the Knoxville Academy of Medicine, Chattanooga-Hamilton County Medical Society and the Tennessee Medical Association.  The TPQVO Board of Governors is elected by its owner-members to govern the company.

2016 Board of Governors:

Eugene Ryan, MD, Chairman, Chattanooga and Hamilton County Medical Society

Glen Newman, MD, Chattanooga and Hamilton County Medical Society

Rae Bond, Chattanooga and Hamilton County Medical Society

John Neff, MD, Knoxville Academy of Medicine

Kim Weaver, Knoxville Academy of Medicine

Yarnell Beatty, JD, Secretary-Treasurer, Tennessee Medical Association

Barrett Rosen, MD, Tennessee Medical Association

Physician and Other Healthcare Provider Database

Currently, TPQVO maintains approximately 8,000 physician, dentist, and other healthcare provider credentials files.  The vast majority of practitioners maintained in TPQVO files are physicians (MDs/DOs).   These files are processed for initial credentialing and recredentialing for over 70 hospital, health care network, clinic, surgery center, federally qualified community health centers, public health service, and home health clients throughout the U.S.

Credentials Verification Standards

TPQVO follows the credentials verification standards set by the National Committee on Quality Assurance (NCQA) for managed care organizations, the Joint Commission for hospitals and surgery centers, and Accreditation Association for Ambulatory Health Care (AAAHC) for surgery centers.  Some hospitals define higher credentials verification standards through medical staff bylaws than those required by Joint Commission.   TPQVO will work with those clients to meet the higher standards whenever possible.

In addition to application processing and primary source verification, TPQVO monitors expiring documents and licenses (DEA registration, insurance certificate, licenses) and obtains new documentation from providers.  This document update service is provided for no additional cost to clients using TPQVO for processing recredentialing information.  Also, TPQVO monitors the HHS Office of Inspector General Medicare/Medicaid sanction reports and state licensing board disciplinary actions and notifies clients of any adverse information regarding practitioners on their current rosters.

Policies and Procedures

TPQVO operates under extensive policies and procedures specifying the credentials verification process, primary sources queried, record confidentiality, security of paper and electronic records, quality improvement and other organizational functions and structure.   Excerpts from the Policy and Procedure are available upon request.

Additionally, TPQVO develops and implements annually a Quality Improvement Plan.  Results from continuous performance measurement are described below.

Credentialing Operations Performance

As part of its quality improvement program, TPQVO tracks the time it takes to complete credentials verifications.  The data tracked from TPQVO’s inception in 1998 through 2015 show only a small percentage of verifications exceeded TPQVO’s benchmark of 90 days for appointments and 60 days for reappointments.  

Turnaround times for processing initial application and recredentialing applications for 2015 reflect the vast majority of files were processed using Joint Commission standards plus additional elements required by individual clients.  Average processing times for initial applications were 45 calendar days for physicians and 43 calendar days for allied health practitioners.  Recredentialing times averaged 40 days for physicians and 46 days for allied health practitioners.  Average times for NCQA standards were one business day of TPQVO receipt of the completed application.

Verifications are complete only when primary source verifications are obtained or there are three attempts to verify the information.  (In those cases, secondary sources acceptable to NCQA and files closed as “incomplete” are not included in the data displayed above.  Clients are notified of all missing documents or information that could not be verified.  Joint Commission standards will be used or clients are notified of outstanding verifications.)  Signatures on attestations are checked to make sure they are current to maintain overall timeliness of file processing.  If a signature is outdated, TPQVO will obtain an updated signature from the applicant to maintain the 120-day wrap around the application and verifications.  Even if an application attestation is refreshed in this way, total days are tracked from the receipt of the completed application.

In addition to file processing indicators, TPQVO conducts routine internal file audits and periodic external file audits.  As part of file processing, files are reviewed before distribution to clients to assure quality on a prospective basis.

Performance Indicator: Client Satisfaction

As part of its Quality Improvement Program, TPQVO surveys its clients each year on twelve dimensions of product and service quality including timeliness, accuracy, communication and complaint handling. 

Since the survey’s inception in 1998, a majority of clients responded to the survey and provided important feedback.  Most clients report they are satisfied or very satisfied with all quality dimensions and 100% of clients stated that would recommend the service to others.   Service dimensions tracked include timeliness, accuracy and organization of appointment and reappointment files, knowledge of the client and overall knowledge, communication and responsiveness to questions and concerns.  TPQVO followed up on concerns noted in surveys and reviewed all comments and suggestions included in the narrative section.


Another way TPQVO gathers feedback from clients is through regular client meetings in the client’s service area.  Clients attend Client Meetings to discuss new products and services, improving services, and other ways to make the working relationship with TPQVO more successful.

Contracting and Delegation

Health care organizations delegate both the responsibility and liability for credentials verification, including National Practitioner Data Bank through a formal written contract for services.   NCQA CVO certification is maintained for the convenience of managed care plan and network clients to simplify the credentialing delegation process.  TPQVO maintains professional and general business liability insurance for the protection of its clients.

TPQVO provides reasonable access to its operations and files by clients for auditing purposes.  Staff is available to meet with organization committees and officers on an as-needed basis. 

Managed Care Credentials Verification

TPQVO is a NCQA certified Credentials Verification Organization in 10 out of 10 credentialing services.

This certification is in good standing through July 2017. 

Allied Health Provider Credentialing

Allied Health Providers are defined as those health care practitioners licensed or otherwise certified but are not included in the definition of medical staff for hospital and health plan purposes.

Client References

Client references are available upon request.

 

For more information, please feel free to contact us.

 

 

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Copyright © 2002 TPQVO, LLC
Last modified: April 28, 2016