Healthcare Credentialing | symplr Blog

From a Doctor's Mouth to an MSP's Ears

Written by Donna Goestenkors | Nov 6, 2014 9:03:00 PM

The following is a summary of a conversation I had with a newly credentialed physician processed by a CVO and then recently appointed to a hospital’s Medical Staff.

Dr. Jennings, Invasive Cardiologist, and I were speaking on a flight to Atlanta. After he and I established our career positions, we began to talk about his experience in the application process. His exact words, “Credentialing? Yes, I just went through a long and involved process and came to the conclusion that this is not the time to make waves and that I better just do what I’m asked to do.” He continued, “Honestly though, there has to be a better way!”  

What were my immediate thoughts?

“Dr. Jennings gets it!” It was refreshing to speak with a clinician who understood that the gathering and evaluating of his credentials must occur in order to validate that he indeed has the ability to provide quality patient care. In addition, I thought how lucky I was that I was having a real conversation about my industry business with a doctor, one who was also a new graduate, who joined a large cardiology group and who was rich in experience, since he had been approved by the Board of Directors just one month before. Lastly, as I was constructing this month’s article I also realized that this conversation with Dr. Jennings was another branding connection about the valuable role that MSPs have in their organizations.

Improving Provider Relations

Improving systems and processes to make our offices more efficient, safe, and risk averse will always be at the core of our business practices. And, in this case, it truly brought to light the importance of working with our providers to support their efforts. If we can reduce their paperwork burden, we free them up to focus on what they do best – provide quality care to our patients.

I had a captive audience in Dr. Jennings! So, I took this opportunity to ask him how our industry might improve the credentialing experience for practitioners. His suggestions, although they may appear simple to many MSPs, can be used not only as a point of reference to measure your credentialing and privileging practices but also as a springboard to ferreting out opinions from some of your practitioners. How can we all work together to improve the credentialing experience for the practitioner and the MSP? Let’s start the dialogue!

Top Five Examples on How Credentialing and Privileging Can Be Improved

1. The Medical Staff Application was too long.

ACTION: Review your application to be sure it includes compliant and only necessary information. Some states and organizations dictate the content of an application. So be it. However, MSPs can make certain that associated inclusions to an application are current, relevant and meaningful. When was the last time you really updated your application and/or application packet?

2. The Payor Enrollment Application includes much of the same information being requested on the Medical Staff Application.

ACTION: Work with your Recruitment Department, Payor Enrollment Department, etc. and all key stakeholders to consolidate needed information to one application. Have you started your outreach?

3. Once I submitted my application, no one notified me that it had been received or kept me informed about its status. I was only contacted when someone needed me to do something.

ACTION: Immediately take action to incorporate a strong ongoing feedback component into your credentialing system. Do you at least advise the applicant that their application has been received?

4. The clinical privilege form didn’t reflect current procedures that an invasive cardiologist would be expected to do.

ACTION: It is necessary and required that an organization’s clinical privileges reflect only those that can be performed at that organization as well as ensuring that the contents of the form include current procedure criteria and defined privileges that are relevant to the specialty. What’s the date of your most current revision to your delineation of privileges?

5. Proctoring requirements did not take into consideration the cases/procedures I performed during my education and training programs.

ACTION: Be sure that the training, education, and procedure log of an applicant are matched with your organization’s procedure criteria as well as FPPE and proctoring requirements so unnecessary work is not being done. Do you present this level of competence information to your Departmental Chief and/or Credentials Committee as part of their evaluation process?

Thanks to Dr. Jennings for sharing his insightful comments!

Colleagues, I hope you found this information to be a helpful starting point on action steps you can take to adjust some of your forms and processes to enhance the experience of the practitioner and improve your products and services. It will serve as a win/win experience for all involved.