Medical Staff Offices Share Credentialing Data?

MEdical Staff Services, Credentialing Software, Delegated Credetialing, CVO, Primary Source Verifications, Credentialing, Provider RelationsI find myself responding to the same question posed by many healthcare organizations “Should our medical staff offices share?” What they’re essentially asking is “Is it better to share the gathering, storing and verification of provider credentials or should each facility maintain individual records?” My response is always the same, “If you’re interested in saving money, increasing reimbursements and improving provider relations, the answer is yes!”

Saving Money

A provider's credentials, and the verification of those credentials, are similar regardless of the facility a provider will be working in. It doesn't make sense to collect the same data, upload copies of the same documents, and call the same sources to verify the same credentials multiple times. Couple this with the fact that it takes weeks if not months to prime source verify all the necessary information and your medical staff will be in a duplicative, never-ending credentialing cycle. For example, organizations with a provider working at four facilities will verify the same credentials four times if choosing not to share data. If processes are consolidated and the workload is shared, the group would only need to verify credentials one time, saving the staff months of time and the organization hundreds if not thousands of dollars.

Increasing Reimbursement

Healthcare organizations recruit providers to fill a void the organization wants to offer or to bolster a specialty where the patient’s waiting time to see a provider drives them to competitors. In response to demand, providers will often see patients prior to completing enrollment with payors and possibly forfeiting reimbursement. When credential information is shared and centralized, it decreases the time between recruitment, credentialing, and enrollment allowing providers to be onboarded faster without these traditional gaps in reimbursement. Faster onboarding is a win/win for all involved.

Improving Provider Relations

Keeping separate credentialing processes from one facility to another creates an extraordinary amount of unnecessary work for staff and providers. Keeping the example above (a provider applying at four facilities) would require the provider to complete four applications, upload or fax four copies of all documents, answer and sign attestation questions four times, and communicate with separate personnel from each of the four medical staff offices. Sharing processes would alleviate redundant work, reduce the provider's enrollment time and allow the provider to do what they do best - treat patients. Making the decision to share information across multiple facilities can reap significant rewards for patients, medical staff, providers and the healthcare organization. Delaying the decision will only cost you - literally!

Provider Credentialing


Melissa Outlaw

About the Author
Melissa Outlaw

Melissa Outlaw is a Vice President, Customer Success with symplr. Melissa and her team assist clients in learning and implementing our provider management software - credentialing, privileging, peer review, quality and event reporting applications. She supports clients in benchmarking current internal practices, identifying potential efficiencies, then driving the integration of technology with process improvement to reduce time of service and operating expenses. She works extensively with decentralized, multi-facility organizations in transitioning to a shared service center as well as assisting healthcare organizations bridge the gap between procedures performed by a provider and their privileges granted.

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