Credentialing

The Mercy of Iowa City Regional Physician Hospital Organization (PHO) maintains delegated credentialing status with the health plans it contracts with.  The PHO performs initial credentialing and recredentialing of its participating providers.

This is a tremendous benefit to PHO providers as it eliminates the need for individual providers or groups to do this separately and independently for each health plan with which they participate.  The PHO’s credentialing and recredentialing also offers efficiencies and effectiveness to the health plans as there are less health plan resources and staffing necessary for credentialing.

The Mercy of Iowa City Regional PHO maintains outstanding scores on the annual credentialing audits conducted by the health plans.  The Mercy PHO follows all National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Committee (URAC), CMS, Accreditation Association for Ambulatory Health Care (AAAHC), and State of Iowa standards.