Outpatient

Staff credential tracking for clinics and physician offices

Four separate audiences read the same personnel file on four different clocks. Nineteen rows are loaded before you type anything, the payer clocks are listed and honestly not loaded yet, and this is not payer credentialing software.

What a clinic has to prove, and to whom

There is no single survey and no single audience. A nursing home has one inspector who arrives with one list; an outpatient clinic or a physician office has four separate readers of the same personnel file, each on a clock of its own, and none of them talks to the others.

The state board, for every licensed person in the building, on that discipline’s own renewal cycle. This is the part everybody remembers.

The DEA, for every prescriber, every three years under 21 CFR 1301.13(e). About half the states add a controlled substance licence of their own on a one to three year cycle, which is a second date that looks like the first one and is not.

CLIA, the moment you run any testing in house, even a waived strep swab. 42 CFR 493.1489 sets who is qualified to perform testing at each complexity level, and for moderate complexity testing 493.1413 adds a competency assessment twice in the first year and annually after that. Practices are routinely surprised by this one, because the CLIA certificate is filed under the practice and the competency is filed under the person.

The payers and the hospital. Medicare revalidation every five years, Medicaid at least every five, CAQH re-attestation every 120 days, payer recredentialing at thirty-six months under NCQA, the malpractice certificate annually, and privileges on a two year cycle. This is where a clinic’s compliance coordinator actually loses sleep, because missing one of them stops the money rather than stopping a person working.

And underneath all four, the rows that bind any employer whose staff can be exposed to blood or a hazardous chemical, plus the I-9 and HIPAA training.

What Credolex loads on the first day

Nineteen rows for a clinic or physician office: eleven for the setting, eight that bind every healthcare employer. Eleven of the nineteen are on the short list, meaning their absence stops somebody working or stops you billing for them. Each row names its basis, and where the basis is a certifying body rather than a regulation it says so rather than dressing guidance up as law.

Clinics and physician offices

RequirementSays whoHow often
Physician licenceState medical practice actEvery two years in most states
Nurse practitioner licenceState nursing practice actEvery two years
Physician assistant licenceState medical practice actEvery two years
RN licenceState nursing practice actEvery two years
LPN or LVN licenceState nursing practice actEvery two years
Professional licence, therapy and social workState practice act for the disciplineEvery two years
DEA registration21 CFR 1301.13(e)Every three years
CLIA testing personnel qualification42 CFR 493.1489Once, before the person performs testing
Specialty board certificationAn ABMS or AOA member boardEvery ten years on most boards
Medical assistant certificationAAMA, AMT, NHA or NCCTEvery five years on most certifying bodies
Tuberculosis baseline screeningCDC 2019 health care personnel recommendationsOnce, within fourteen days of hire

Every healthcare employer, whatever the setting

RequirementSays whoHow often
Federal exclusion list screeningOIG Special Advisory BulletinEvery month
Basic life support certificationF678 · 42 CFR 483.24(a)(3)Every two years
Form I-98 CFR 274a.2(b)(1)(ii)Once, within three business days of the first day of work
Hepatitis B offered or declined29 CFR 1910.1030(f)Once, within ten working days of assignment
Respirator fit test29 CFR 1910.134(f)Every year, and on any change of make, model or size
Bloodborne pathogens training29 CFR 1910.1030(g)Every year
Hazard communication training29 CFR 1910.1200(h)Once at assignment, again when a new hazard arrives
HIPAA privacy training45 CFR 164.530(b)(1)Once, within thirty days, and again on a material change

The payer clocks, which are not loaded yet

Everything in this third table is a real recurring date and none of it is in the shared library today. Each one fits the model as it stands and can be added as your own requirement in a couple of minutes, with its own name, its own cadence and its own cited basis, and it will behave exactly like a loaded row: same statuses, same reminders at 30, 15 and 7 days. It is listed here so you can see what you would be adding, and so nobody discovers the gap after signing up.

RequirementSays whoHow often
Medicare revalidation42 CFR 424.515Every five years, and every three for DMEPOS
Medicaid revalidation42 CFR 455.414At least every five years
CAQH re-attestationPayer contractEvery 120 days
Payer recredentialingNCQA credentialing standardsEvery thirty-six months
Malpractice certificate of insurancePayer and hospital contractEvery year
Hospital privilegesMedical staff bylawsEvery two years
State controlled substance licenceState law in roughly half the statesEvery one to three years
CLIA competency, moderate complexity testing42 CFR 493.1413Twice in the first year, then every year

Whether these become loaded rows depends on whether clinics actually sign up. Credolex was built for skilled nursing first and the outpatient library is the newer half of it, so the honest position is that the licences, the DEA and the CLIA rows are shipped and tested, and the payer side is researched and waiting for a reason to build it. If you are a clinic and this is the half you care about, say so when you request access.

What we do not do

This is not payer credentialing software. No CAQH sync, no enrolment applications, no delegated credentialing file, no primary source verification against a board, no roster submission. If what you need is to do credentialing rather than to not miss a date, Medallion, Verifiable and symplr exist and are built for it. Credolex tracks the dates that credentialing produces. That distinction is worth being clear about before you spend an afternoon importing a roster.

We are not a learning management system. The HIPAA module, the bloodborne pathogens refresher and the CLIA competency assessment happen wherever they happen now. Credolex records that they happened and when the next one is due.

We are not an EHR or a practice management system. No charting, no scheduling, no claims. The only overlap is that some of the same people appear in both.

And Credolex is not regulatory advice. Every citation above is there so you can go and read it; the practice stays responsible for its own compliance.

Questions people ask about this

Does this do payer credentialing?

No. There is no CAQH sync, no enrolment application, no primary source verification and no delegated credentialing file. Credolex holds the dates that credentialing produces and tells you before they run out. If you need software that performs the credentialing itself, this is the wrong tool and it is better to know that now.

Are the Medicare and CAQH clocks in the list?

Not as loaded rows. They are real recurring dates and they fit the model exactly, so you can add each one as your own requirement with its own cadence and its own citation, and it behaves like every other row. The reason they are not preloaded is that the outpatient library is the newer half of the product and nobody has asked for them yet.

Does it handle CLIA competency assessment?

The personnel qualification under 493.1489 is a loaded row. The competency assessment under 493.1413, which is twice in the first year and annually after, is not, because a clock that changes cadence after the first year is worth building properly rather than approximating. Added as your own annual requirement it covers the ongoing half correctly.

We are a two-provider office. Is this overkill?

A two-provider office with four staff is inside the free tier, which is every feature and not a trial. The list starts on eleven short-list rows rather than nineteen, and a practice that size is usually set up in under an hour. If it turns out the dates you care about are all payer dates, the honest answer is that this is not the tool yet.

What does it cost for a clinic?

By headcount rather than per provider or per seat: free to ten people with every feature, $39 a month to twenty-five, $69 to fifty, $129 to a hundred, $229 to two hundred. The front desk and the medical assistants count the same as the physicians, and adding your office manager as a second coordinator costs nothing. The pricing page has the full breakdown.

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