Monitoring Healthcare License Boards: How to Hit a Moving Target


Why other verification systems fail and how we’ve adapted.

For healthcare organizations, verifying and managing provider licenses is critical for compliance, credentialing, accreditation, billing, and patient safety. Many of our clients come to us after their previous solution could no longer keep up with their needs and had created an administrative burden that was no longer sustainable.

These are the two scenarios we most often hear from large organizations (beyond those still struggling with their own manual verification work) in need of smarter license verification technology: 

  1. We built our own solution and it can’t keep up with board changes.
  2. Our vendor keeps sending us more and more unverifiable licenses.

In both of these scenarios, the resulting pain points include tedious manual verification tasks for thousands of licenses and significant time delays

What causes most license verification technology to break?

State license boards are not static data sources: they frequently change the location, format, and security measures around their data. In the case of most solutions, this creates “unverifiable license” results and generates quickly accumulating manual tasks for the teams that rely on automated license verification technology. 

Data changes are one of the reasons why ProviderTrust champions ongoing license monitoring—license statuses and effective dates change for both benign and alarming reasons. This year, for example, we’ve seen many boards categorically extend expiration dates due to ongoing emergency orders, and disciplinary actions for some providers flouting PPE safety. 

Not only do the license details change over time (and much more frequently than every three years), but the boards themselves evolve as well. They update their websites, enhance security safeguards, manipulate license data formats, and otherwise change to meet the needs of the people and organizations they serve. 

Even if your organization made a significant initial investment to build an internal solution to automatically verify licenses, keeping it running requires real resources to maintain continual development and IT infrastructure support. 

Top Three Scenarios Cause Most License Verification Tools to Break

  1. The URL changes
  2. The file format or search interface changes
  3. The board adds enhanced security (e.g., CAPTCHA)

Every time a license board makes one of these changes, it can cause a verification tool or scraper to break. If you’re running a small practice and only dealing with a few license boards, this may not be a big deal. But like any other data challenge, the impacts of seemingly small changes can be massive for enterprise organizations, creating huge backlogs of work and delaying verification by weeks or months. 

How Frequently do License Boards Make Changes?

In a given quarter, between 15-20 license boards make changes that require deployment of development and IT resources to continue monitoring that board’s data. In one year, up to 20-30% of healthcare boards make the changes and monitoring tools must be adjusted. This is an ongoing maintenance task for ProviderTrust, but creates a prohibitive amount of work for healthcare organizations that set out to build their own license monitoring solution. 

For many vendors, passing this work back to you is just part of doing business. They might adapt their process or technology eventually, but your team will have to pick up the slack in the meantime. If you have an enterprise employee base or provider network, this means continual manual propping up of a subpar solution. 

Smarter License Verification Makes for Better Workflows

Smarter primary source license verification can play a critical role in workflows across the healthcare continuum. From enrollment, contracting and credentialing of new network providers to processing orders, referrals, prescriptions, and claims, faster and more accurate license verification can empower more efficient and reliable workflow outcomes by identifying fraud and compliance issues at the point of decision. Powered by data enrichment and deployed via flexible integrations, instant and ongoing license verification is critical to smarter and safer healthcare. 

The ProviderTrust Difference

At ProviderTrust, we know that having to accommodate unforeseen work just to get back to the result you thought your vendor was providing (full verification for 100% of licenses) isn’t good enough. We’ve engineered our tools, processes, and teams to ensure you never receive unverifiable licenses. 

The minute a license board makes a change, we know. And our dedicated team updates our tools to ensure continuity of service. If a board requires temporary manual verification, we do that work, too, delivering only accurate, verified results. 

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