How do you manage vendor credentialing | GHX
Friday, July 15, 2016

How does your organization manage vendor credentialing?

posted by: Adam Josephson

Vendor representative credentialing has grown significantly in priority - and changed in scope over the last several years with increased regulatory requirements. As the importance for a process became more and more apparent, many healthcare supplier organizations developed programs based on the immediate need or circumstance, with some evolving over time.

Interestingly, we usually see one of four models in practice today. The chosen approach can be generally associated with company size, number of representatives requiring credentials and available resources to help with credentialing. The question now…does your current approach serve your organization?


Four Models for Managing Vendor Credentialing


Representative Managed

In a Representative Managed model, reps are left to figure out and handle credentialing requirements on their own. The employer tells the representatives that meeting these requirements is their responsibility. This is common in small organizations, but even some of the largest healthcare vendors follow this practice as well.

This model can be a challenge for many representatives because representatives are typically results, not process, oriented. Even though asking reps to assume this responsibility is in contrast to what are considered the traits that lead a sales rep to success, we estimate 60% of vendor companies take this approach.


In this model, there’s some level of corporate support to help the representatives, but the reps are still on their own for meeting some requirements. Typically the corporate support is for company documents and payment. The representatives are held accountable for managing any training or immunization requirements.

Many companies use this model so they are sure that their brand and overall customer relationship is managed without the complexity of addressing each individual representative’s status. We see roughly 25% of the vendor companies take this approach. It is a good way to get started, but there is much room for improvement in getting reps sales ready and managing your compliance obligations.

Fully Managed

The most under-utilized approach is a credentialing program fully managed as a corporate function. A specific corporate staff member has oversight and day-to-day responsibility for ensuring representatives meet all credentialing requirements appropriately. Representatives tap this resource for official company documents, for company guidelines about which policies are appropriate and which are not, and for assistance in finding approved resources for training, etc.

This model results in higher numbers of representatives being fully compliant with their customers’ requirements, and the company is able to centrally manage moves, adds, changes, and deletes to their representative staff and territories. Current estimates are that 1 in 10 companies adopt the fully managed model, but that number is growing.


Obviously in an outsourced model, a third party is contracted to ensure participation and compliance. The supplier may outsource all of the credentialing needs or just specific areas. Companies adopt this method to ensure high levels of compliance without the expense and complexity of building credentialing expertise in house.


Regardless of the approach your organization has taken, the important thing to determine is how well it serves your organization. As you review your process, consider if and how the importance of credentialing is communicated across your organization. Also, solicit honest feedback from your reps – this can offer clues on prioritizing changes and it reinforces the importance of credentialing if it is part of an ongoing dialog. We have experienced that the more formalized the process, the greater the adoption as well. As such, suppliers that have some element of a managed function tend to have greater compliance rates, and the rate increases the more credentialing is viewed as a corporate function.

Let us know how we can help. Learn more about Vendormate Credentialing.