Healthcare Credentialing | symplr Blog

4 Steps to Mastering Centralized Credentialing in a Multi-Hospital System

Written by Janice Benggio, CPMSM, CPCS, CPHRM | May 24, 2016 2:30:00 PM

Centralization the credentialing process in a multi-hospital system should be a team effort. In a hierarchal structure, there is a tendency to keep processes separate, an attitude which largely comes from different departments specializing their credentialing processes in a way that best fits with the dynamics of their departments. However, decentralization can be highly inefficient and unsustainable in an industry that is increasingly experiencing more and more integration.

 Below are the four steps to mastering centralized credentialing so you can keep up with this integration.

Step 1: Understand Specializations within Multi-Hospital Systems

The goal of centralization is to have an effective credentialing system that reduces credentialing redundancies and errors, leading to a greater quality of service. However, there are things to consider before attempting to centralize your hospital’s credentialing system.

Multi-hospital systems work well because they are able to access a wider range of facilities, tools, and specialists. Within a system, the cost of hosting a facility can be applied to scale – leading to savings within the system. When attempting to centralize a credentialing system, administration needs to be aware of variations in talents and specialization within their systems. These specializations should be reflected in the central-bylaws and policies of the system.

Step 2: Acknowledge the Sensitive Nature of Roles and Responsibilities

A major goal for centralizing the credentialing process is to streamline communications for optimal time investments. However, it’s important to take into account the depth of responsibilities that certain administrative or managerial roles have within their departments. Effective management comes from placing decision-making authority closer to its sphere of influence. Centralizing credentialing authority may lead to role changes or rotations in responsibility, leading to faults where diligent authority is needed.

The key to realizing the full-benefits in centralizing your credentialing process is to approach the task with input and guidance from the stakeholders. This is done best through the efforts of a team whose purpose is to provide feedback and resolve any uncertainty.

Step 3: Find the Right Size of Team

Finding the right size of the team can be difficult, as there are many factors that come in to play when creating a comfortable level of representation for all stakeholders. Having a team that is too small will limit the value of your feedback, having too many and your feedback will be diluted.

The size of the team should factor in the number of facilities, departments, and the number of medical staff within each department. Depending on the organizational make-up of your multi-hospital system, it may be beneficial to have at least one representative from each facility to join the team.

Also, you will want to take into account the level of participation needed from each representative. Some roles have tighter time constraints and will require revolving representation.

Step 4: Identify the Key Roles Within the Team

Massive multi-hospital systems may benefit from creating committees within teams to help stakeholders come to a consensus on divided matters. Multi-hospital systems with major size differences among facilities may find it helpful to use unique voting rules amongst clusters of stakeholders (i.e. 2/3rd majority, simple-majority, unanimous decision).

However you decide the dynamics of your team, there are at least three roles that must be present:

  1. Team Leader

The team leader holds the most important role as he/she is the final decision-maker, mediator, and historian. This role requires someone who is consistent in attending all meetings and is comfortable with making decisions. He/she must be open to feedback and appreciate all input when guiding the creation of new credentialing policies and bylaws.

  1. Medical Staff Services Professionals

The medical staff services professionals represent their stakeholders and are knowledgeable of their practice’s credentialing processes and operational needs. These roles are open to any professionals, but it is recommended that they are occupied by management, credentialing staff, chief medical officers, and/or a credentials committee member.

  1. IT or Technical Advisor

There must be at least one IT professional or technical advisor who is able to provide input in the implementation of technical changes. Centralizing your credentialing process will require highly technical work, ensuring the security of information exchange, storage of sensitive data, and provide authorizations.

It is difficult to create a centralized process in isolation, so the purpose of the team is to provide knowledge and stakeholder support in the centralization process. With the support of stakeholders, the centralization process receives the knowledge and technical support needed to carry over specialties that give value to the system. 

To learn more about centralizing the credentialing process of multi-hospital systems, listen to our symplr education series webcast titled, Centralizing Credentialing in a Multi-Hospital System.

At symplr, we understand the frustrations that come with credentialing a highly diverse medical staff. Which is why we’re offering you a free demo of our symplr credentialing service today!