Credentialing automation platform Baton Health launches Universal Primary Source database

Steven Loeb · May 1, 2024 · Short URL: https://vator.tv/n/5876

That gives its customers access to hundreds of PSV databases through a single query

Healthcare credentialing is the process by which every hospital, health system, provider group, payer, and state licensing board performs background checks on doctors to verify all of their information.

This is done every two or three years, but it's an outdated process that's still done manually, meaning it's both inefficient and expensive. Workflow can span from two to six months, costing practices over $200,000 per month per practitioner in lost revenue due to delayed credentialing. 85% of credentialing applications contain errors or omissions, and 30% of these mistakes are serious enough to require corrective follow-up with practitioners.

"If you think about every single person in healthcare going through this every couple of years for every one of those relationships they have, you realize that there are not just hundreds of thousands of cases, or millions of cases, but hundreds of millions of events, every single year, where we're doing the exact same workflow. When you realize how much of that workflow is entirely manual, that's when you realize the magnitude of the problem," said Robert Coombs, founder and CEO of Baton Health, a company automating the credentialing process.

On Wednesday, Baton announced the launch of its Universal Primary Source database, allowing its customers to access hundreds of PSV databases through a single query.

"At Baton, what we’re building is a utility that can serve hospitals and health systems who have in-house credentialing teams, those CTOs and BPOS who are the outsourced service providers, and then also the payers who are using this data for payer enrollment, as well as credentialing software platforms."

Baton Health's platform takes repetitive manual data entry and instead provides access to data from a network of state, federal, and specialty databases. That means that physicians, hospitals, health systems, payors, and Credential Verification Organizations (CVOs) see a reduction in costs, time, and liability resulting from inaccurate data.

“Baton works with many different players in the healthcare space––anybody who is in the credentialing or licensing or payer enrollment workflow,” said Coombs. 

"Interestingly, if you think about this like a utility, it's just a repository that's out there, that's federated all of this information into one location," Coombs explained. 

"Now we're starting to talk to folks who are using this information as a hiring screen. So, rather than waiting until someone has already gone through the credentialing process, they can save themselves lots of time. So, we don't actually replace a credentialing team or credentialing software, we just supercharge them and unlock capabilities that otherwise have been stuck in the dark ages."

Right now, Baton is being used by roughly 30 organizations, who the company refers to as its "design partners," including MocingbirdThe Clinic by Cleveland ClinicAmwell, and Brevard Health Alliance, a Federally Qualified Health Center in Florida.

These companies have helped validate Baton's approach and started giving feedback to help construct the platform. For  example, Amwell was one of Baton's very first design partners and helped the company realize the power of its platform for licensing teams.

"We've had a few more folks come in off the waitlist, and we're chipping away at that, but we have more than 100 organizations on our waitlist, so it's taken us some time to start bringing them in," said Coombs.

An example of how a customer might use Baton is to pre-populate their applications to avoid errors that cost additional time and money.

"Credentialing can take anywhere from two to six months; one of the biggest reasons for that delay is because 85% of all applications start out with errors or omissions. The team that's receiving that application has to try to reconcile those. About a third of the time we can't, so we have to go back and get in touch with the practitioner, get them to fill in the blanks. That's part of what drags this on," Coombs explained.

"Now imagine if you had flawless data and it was comprehensive, there are no licenses left off of the application, etc. That's the single most powerful thing that you can do to make sure that those applications get processed in a timely manner."

Another use case is to do primary source verification for every single piece of information that the applicant gives, rather than going out to every single primary source manually, which would mean reaching out to more than 300 distinct databases just for licenses.

A more recent use case has been to use Baton's database to instantaneously verify the licensure and the status of that individual without having to go back to the primary source and verify it, which is particularly helpful for telehealth and virtual care. 

For example, Baton has been working with the Virtual Second Opinion program at Cleveland Clinic, called The Clinic by Cleveland Clinic, to help solve a problem that they've been having: their specialists who are already credentialed at the Cleveland Clinic are the individuals that a patient might be booking a virtual second opinion with.

"As is the case for all telehealth and all virtual care, you have to be licensed in the state where the patient or person that you're seeing is at the moment of the appointment. And so, it's a really challenging thing because all of these specialists are licensed in Ohio, that's where the Cleveland Clinic is based. But if a mom in Nashville wants a virtual second opinion from the world's leader in pediatric cardiology, we know where to find that," said Coombs.

That means that, as these appointments are getting booked, The Clinic is able to instantaneously verify the licensure and the status of that individual without having to go back to the primary source and verify it.

"So, it's a really interesting compliance case. And it just shows how, particularly with telehealth and virtual care delivery, the complexity and the timeliness of this data has really increased."

All of this results in ROI that can be as high as 95% savings on primary source verification. For example, Amwell, which has an active roster of more than 9,000 practitioners, has credentialed over 17,000 practitioners over the last five or six years;  they've spent between 20 and 25 hours of manual data entry on just one of those practitioners. Baton, on the other hand, is able to query every single license for that one individual practitioner in 645 milliseconds.

What the company is really trying to do, Coombs explained, is take one of the most behind the scenes, but ubiquitous, problems and simply eliminate it. As a result, credentialing will get faster and more accurate, licensing and payer enrollment can be streamlined, and practitioners can know where they are in the process.

"We can take a really, really expensive part of the onboarding process to make it better. In many ways, this is something that everybody suffers because of, but practitioners perhaps suffer the most. So, we simply want to take this and move it from the leading cause of workforce burnout for many of these teams, and just put manual data entry off the map for them. They can focus on all sorts of other much more complicated problems," said Coombs.  

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