Explore symplr's library of articles and resources that aim to make your healthcare credentialing, privileging and provider enrollment processes simple.
Medical staff services departments (MSSD) that partner with remote or third-party credentialing verification organizations (CVO) augment their staffs for the crucial tasks of primary source verification (PSV) or payer enrollment. As a result, synchronizing efforts is essential for success. It might entail creating zones or boundaries, adjusting policies or processes, beefing up communication channels, or adopting new tech protocols. Even internal CVOs that don’t share the same physical space as the MSSD likely can identify areas where they’ve embraced a lone wolf policy that doesn’t contribute to the cohesion of the whole. Cultivate these five habits to strengthen the medical staff/health plan and CVO partnership when remote staff are used.
Medical credentialing success is more journey than destination. In this series, symplr explores areas where the healthcare landscape creates an evolving path toward best practices. We focus on tangible checkpoints, goals, and reminders to help you maintain credentialing excellence. In part 1: Advanced practice professionals are poised to shoulder a greater percentage of primary and specialty care, warranting a close look at policy and procedure for these clinicians.
Every role in managed care today is data driven, with success measured incrementally toward higher quality healthcare delivered at a lower cost. Practitioner data is at the center of it all. According to CAQH, a typical practice holds 12 managed care contracts, with each health plan requiring roughly 140 data elements. For a practice with five practitioners, this equates to managing 8,400 data points.
When it comes to technology for managing clinical privileges, it’s fair to say we’re living in the golden age. Not long ago, paper applications and manila folders ruled the day. Hospitals presented practitioners with unwieldy lists of procedures dubbed “laundry lists.” Physicians checked the boxes next to the services they asserted the qualifications to perform. Veteran MSPs even recall physicians who drew a vertical line down through all the boxes indicating they should be granted every privilege on the list.
Some may call you a medical staff services department whiz or maybe you’re new to the profession. You could even fit somewhere in between. Take our 10-question quiz to discover where you rank in terms of your knowledge of medical credentialing, clinical privileging, and payer enrollment! (Answers and score key at bottom)
By now you've heard of blockchain, a new buzzword in healthcare but one that's been around much longer in industries like finance. Think Bitcoin and cryptocurrency.