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Introduction

Poll Question

Credentialing Challenges & Expected Spikes

Streamlining Credentialing Processes

Bylaws and Process Revision

Understanding Accrediting Standards

Utilizing Resources Efficiently

Measuring Process Improvements

Building Strong Relationships with Practitioners

Positioning as a Strategic Leader

Recruiting and Retention Strategies

Question & Answer Session

 

Introduction

Welcome to today's webinar, The Surge is Coming: Prepare now for credentialing spikes. My name is Cynthia Koeneker, and I'm part of the marketing team here at symplr. On behalf of symplr, we truly appreciate you spending time with us today. We know you have a lot of activities competing for your time. Before we get started, I'm going to run through a few quick housekeeping items, then I'll hand it off to our speakers, Amy and Griselda.

We are broadcasting live today. With that all lines are on mute to minimize noise.

We ask that you use the Q and A box on Go-To webinar to submit your questions throughout the webinar, not the chat ideally.

The Q and A box is what we'll be monitoring.

We look forward to hearing your feedback on how today's session went for you. With that, we ask that you stay online for a brief survey after the webinar has closed. We always learn from those and rate ourselves and see how we can learn and get better for the next session.

By attending live, you will also earn one CE credit from NAMS. Your certificate will be emailed to you in the next day or two. Keep a lookout in your email for it. We will also be sending out the recording via email and your thank you for attending, email.

With that, let's introduce our speakers.

Amy Magnus and Griselda Mendez will are be our presenters and speakers today.

I'm going to let each of them say a little bit about themselves, and then we'll roll into it.

Good afternoon, everyone. I'm Amy Magnus. I'm the director of Credentialing Operations.

I have been in the industry for about ten years now. And before joining symplr CVO, I held, multiple positions in medical staff offices of a critical access hospital as well as an acute care hospital.

In these roles, I gained experience in credentialing, privileging, quality assurance, including FPPE and OPPE and policy management. I also have the opportunity to work in risk management and peer review, which I feel definitely, gave me further insight into that practitioner life cycle.

Additionally, I successfully created and implemented the FPPE and OPPE programs as well as streamlined, the existing credentialing processes.

And then currently, I do continue to provide consultation to many of our customers on, many of these elements as well.

Good afternoon. My name is Griselda Mendez. I'm a credentialing manager. I have fourteen years of experience in the health care field with a background in credentialing, privileging, as well as human resources.

I actually started my career in health care, working in a human resources department of an acute care hospital before I transitioned into a medical staff role. While in that medical staff role, I also served as the site coordinator for our third and fourth year medical students and I worked closely with our graduate medical education department as we were establishing two residency programs at our hospital.

Poll Question

We want to learn a little bit more about you and your organization, so we will have some poll questions throughout today's presentation.

And with that, we will actually move into our first poll question.

The first question is, how many providers does your organization typically credential in a year?

If you'll utilize those answer options, there and we will leave this up for just a minute to collect your responses and then we will kind of go over the results.

Alright. We'll close it out in just a second.

There's still a lot of people voting, so we're going to give everybody an option here. But we'll close it in five seconds here.

Four, three, two. Countdown. Alright. Perfect.

It looks like we’ve got a mixture of numbers here, but we are looking at some high volumes.

Hopefully, our presentation today will assist you with those that are, you know, dealing with a lot of high volume, on a yearly basis.

So again, today, we would really like for this to be an open conversation, and we'll address some of your biggest credentialing challenges.

We're all within different positions within our organization. Some of us may work for hospitals, some of us for payers, but ultimately, we all share the same common goal which is to ensure the safety of our patients and our members. The main goal of this presentation is to leave you with clear action items to help you improve your organization.

Some of the things that we'll cover today are examples of unexpected as well as expected credentialing spikes, how you can streamline your credentialing process, why it's so important to develop a good, relationship with your practitioners through that credentialing process, and how you can position yourself as a strategic leader within the credentialing field.

We want you to ask questions, so please again utilize the Q and A for any questions that you may have, and we actually have another poll question coming up for you.

Awesome. So, again, we do want to hear from you. What is your biggest challenge that you face in your role today?

Some of you might have more than one, Choose the best one, that fits your current circumstances.

We will leave this open for about thirty-ish seconds for you to vote and we'll share those results.

Quick question while we're letting the poll on, what would you what would you anticipate, the results to be given our past experience here, your past experience?

From what we typically see, and I know from past experiences of how I felt in the NSO, is typically going to be your staffing.

And there we go.

There it is.

It looks like about forty percent of you stated it's your sufficient staffing and or turnover.

And then the runner-up is our inefficient workflows, which absolutely makes sense.

Which perfectly actually ties into a survey that we've conducted last year.

It was our state of medical staff survey that, conducted again, last year in 2023 where nearly seven hundred MSPs just like yourselves across health system hospitals and large physician group practices participated.

And as you can see here, obviously, 64% said that turnover was one of the main things impacting their department.

However, we did identify three significant takeaways as well. So as stated, our medical staff offices are working more with less people, which impacts your day-to-day operations and potentially causing an unmanageable backlog.

On average, teams are using three or more software solutions and or spreadsheets, to complete the credentialing and enrollment processes, which then results in our MSOs struggling, to collect, manage, and maintain those massive volumes of data as you're toggling between the multiple systems and solutions.

Lastly, we found that inefficient processes with little automation are causing credentialing delays and those backlog claims.

Credentialing Challenges & Expected Spikes

I will hand this off to Griselda.

First, let's discuss some examples of expected as well as some unexpected spikes. So unexpected spike could be if your organization happens to lump your reappointments to, say, a particular month of the year rather than processing your reappointments on a monthly basis.

Amy, I think you've experienced this yourself in your previous hospital.

Yes. So, within my, medical staff office, at the critical access hospital, very small medical staff. So, we did lump all of them together. One half of medical staff was one year, half was the next. So, I expected January of every single year I was going to have a larger volume than I typically would have throughout the year.

We also know that new practitioners will be entering the workforce every year at the completion of the residency training.

ACGME approximates that fifty thousand practitioners will complete residency each year, and we'll see that number continue to climb. So again, because we know when they'll complete, we kind of can estimate when we'll see that spike.

We may also see some seasonal spikes. So if you're in a tourist community or in an area that does experience a higher population during certain seasons of the year, like, say, summer months because you're near a beach area or winter months because you're near a ski resort, that you can see those or expect to see those spikes based on seasonality. And the same would be true during seasonal illness time like flu and RSV where we see an uptick in patients needing care, we can see that spike with practitioners needing to be credentialed.

We also know that our practitioners will not work forever, they will retire. As you can see from one of these AOA headlines here, AMA also conducted a survey in 2021 that showed that twenty percent or nearly one out of five practitioners said that they plan to retire in the next twenty-four months. So, then we're left to fill that gap, so we have to bring in new practitioners to provide the care that is needed for those patients.

So now we'll move into some examples of unexpected spikes. So that could include mergers and acquisitions as you can see here from the Becker's hospital review headline, hospital mergers and acquisitions has hit a four year high, and we both again have experienced this particular unexpected spike in our previous roles.

Yeah. So, Griselda and I, fun fact, actually worked together, in a medical staff office, and we were both very new to our roles there. They decided that with the acquisition of the local surgery center that they wanted to bring that credentialing in house to our medical staff office, which, of course, typically is not going to be an issue.

But at this time, it was 2021-ish so shortly after COVID. And, you know, reviewing what has been done, ensuring, you know, the reappointments are still kept up to date, which ones might need to be redone.

And so those were adding, you know, significant increases, into our medical staff office at the time while, again, we're still learning the ropes and really getting comfortable, within the department.

Yes. And based off of the results that we saw from the survey, staff turnover. I mean, we're still seeing that with hospitals that are struggling to deal with staffing shortages. So that can also cause spikes, and also epidemics and pandemics. We're all quite familiar with that one, from COVID.

And another example which again I've personally been affected by is the replacement of contracted groups. In my previous role, at my previous hospital, we actually had a contracted group to provide anesthesia care, and then with very little notice we were notified, hey, this new contracted group is now going to take over anesthesia services.

So, we were left with about two weeks’ notice to now credential about twenty plus, practitioners because that's when this new contract was going to go into effect.

Then, of course, I also had one of the experiences.

We have plenty of all these experiences that we have dealt with, so, we know exactly how you're feeling.

My previous role, had to do with radiology group, and they were telemedicine. So, they were by proxy. Thank goodness.

But this was still a hundred plus practitioners that needed to at least be approved and collect that information.

And I was given about a two monthly way, to send them to committee, which, as you all know, is not a lot of time. During that time, I also had to ensure the contract had that appropriate language to cover us for that proxy credentialing, and we were accepting their decision making as well. So, again, it needed to be worded appropriately and the agreements in place to allow us to do such.

And again, it has to do with the workflows and how information was transferred back and forth. So, we went from one radiology group with a hundred plus practitioners and then, resigning all of them to this other radiology group of a hundred plus practitioners.

With that in mind, we can now start looking at some solutions, some ways to mitigate those spikes.

Streamlining Credentialing Processes

• Simplify processes
• Know your Bylaws
• Know your accrediting standards
• Utilize resources efficiently
• Measure improvements

Of course, the big topic of streamlining your credentialing processes, so it is important to review and update those processes regularly to ensure efficiency and compliance with your accrediting standards.

Avoid sticking to outdated processes and be open to making improvements.

I often hear from many organizations that this is how we've always done it.

But is it really even the correct way? Is it the most efficient? Is it even really appropriate?

So, this is where it's really important for you to understand and can speak to your bylaws, your accrediting standards, and your state regulation. Just remember state regulations and law always trump your accrediting standards. So, it's very important to understand, what those laws state is regarding your credentialing.

Now with our customers, we do often see things that are not necessarily required by accrediting standards.

And honestly, this is the case for many organizations.

So, this is where simplifying your processes comes into play. Ask why those additional elements were added.

If the answer was, this is how we've always done it, that might be an item that it is time to review and ensure that it really is even needed.

We did provide, in the handout a checklist, that lists really basic required elements of both joint commission as well as MCQA.

Again, these are just minimum requirements, of those credentialing processes.

Your bylaws might require, additional items and, just kind of keep that in mind. But I did kind of add additional notes, there on the checklist, that tie back to your bylaws or, policies and procedures.

Yeah.

And that I'll also note with those checklists, what you'll start to notice is that sometimes, multiple departments will be asking for a lot of the same information. Something you can certainly consider and think about is working together with those other departments that may also be affected with you credentialing a practitioner and be able to work together to limit the number of requests that are being sent out to the practitioner for a lot of the same information.

Yep. And I also did it in my medical staff office of working side by side with our peer enrollment department.

They were given the documents that they need, and we just were in constant communication.

We still to this day within our CBO, you know, we have our dual processes as well and we work side by side with them often.

So just have to keep that in mind of how we can, again, simplify that process especially for the practitioner.

So, as I stated, know your bylaws. If you're more from the health plan payer side of things, obviously this would be your credentialing program, your policies and procedures, but, you know, it governs your credentialing process.

It often is heard it's in our bylaws, but the biggest thing is that they can always be changed.

So, the medical staff and your leaders are looking to you as their subject matter expert on the appropriate credentialing process and to ensure that you are remaining compliant.

One big example, which if you are in a joint commission accredited organization and have really good knowledge of your standards or maybe you are also studying for your certification exam, you might know that credentials committee is not required by joint commission.

You'll see in their department chair, medical executive committee or medical staff as a whole and then the board, but there's never mentioned a credential committee, but a lot of organizations do have a credential committee.

Now my MSO, we did remove, that step in the process.

So, again, going back to critical access with a small medical staff, ultimately, the attendees of our credentials committee were the same as our medical executive committee.

So rather than trying to find some time in the month another seven thirty-eight in meeting for the practitioners, we decided and made that executive decision to go ahead and remove it and proceed with the credentials review within medical executive committee. So that not only removed that and took the less burden on, but our practitioners also who are, you know, willing to participate in these meetings, and again, remove that whole step in the approval process. So, it made the files go a lot quicker.

Bylaws and Process Revision

And now when it comes to your bylaws and your process, the revision procedure is created for a reason.

Typically, when we're looking at improvement, a lot of time, your medical staff will ultimately appreciate the change because it removes the burden off of them.

That revision is included so we can, make those necessary steps as needed.

Also, in your bylaws or your policies and procedures, you need to be cognizant of your timelines that you have listed in there. Griselda mentioned, the residents that are going to be completing their program come June.

Now you have to think about what do your bylaws state, as far as your time frame that you have to get that filed to committee?

So, we'd never want to credential them too early, but obviously we want to start in enough advanced time of being able to complete as much as you can to then add in that last verification to send it on to your committee.

Also keep in mind if you have exhausted effort time frames, within your policies as well, so those need to correlate with sending it to committee on time, again, credentialing them in an appropriate amount of time.

Also know your committee date. So that reappointment example of how I lumped, my committee or my three appointments together, again, they were due January of every year. Well, of course, that is around holiday time, and so our board meetings were actually scheduled differently, around that time. And so I had to be aware and make sure that I sent out those notices in advance, have a deadline, an appropriate deadline, be able to process that spike of files coming into my office and then, send it on to our medical executive committee to the board and then to the board, which the end of December was beginning of December.

So then, of course, became effective in January and not miss that credentialing date. So, you know, that is one example. Not everyone has, that kind of situation, but it's also good to know so you can communicate those committee dates to your practitioners and have a general idea of when they might be expected to go through the approval process.

Understanding Accrediting Standards

If you don't understand your standards, every accrediting organization has some type of mechanism to submit a question. So, I highly suggest, you submit a question to them to receive that clarification.

And we all know these standards can be very clear as mud and how one how one person might perceive one standard, another person might perceive it a completely different way.

Ask your questions. They are there to really assist and work alongside you to make sure that you fully understand exactly what they're meaning by those standards.

And then also keep that documentation, for future reference. So, if anybody ever questions why something was changed, even if a surveyor questions why it was changed, you have that documentation to back up that improvement.

Utilizing Resources Efficiently

Utilizing your resources efficiently can reduce repetitive and time-consuming tasks. So, strategies and tools, are available to work smarter and faster while maintaining your accuracy.

As a brand new, MSP in the field. When I initially was being trained, I learned that at well, at the time, I was taught AMA was only used for education and training. But meanwhile, we're going out to the licensing board to pull the verification. So just the DEA to pull the verification.

Go into your certification board to pull the verification and come to find out, you know, AMA verifies every single one of them.

You know, AOA as well. And so, I was able to reduce all of those individual verifications onto this one. And so that took out a lot of additional steps I had to take internally, to satisfy all of those elements.

MPDV is another example. And so, I understand that some organizations might not have MPDV due to, a peer review process.

And, yes, individual verifications will actually have to be pulled. However, know those reports that are actually pulled on the NPDB.

You know, there's OIG, SAM, OFAC, Medicaid exclusions. We see often malpractice history going direct to carrier. I understand these sometimes can be, again, listed in your policies and procedures or bylaws, but, again, ask this question. Why are they, being required to be pulled separately when MPDV does report on all of those individual elements and satisfies those items?

Also avoid manual spreadsheet, so utilizing outdated software or even paper files. I'm sure many of you, have had experience of tracking on an Excel spreadsheet, and also processing in paper files. Some of you might still be doing that. But utilizing the technology that is available and with an efficient software can help in this regard.

Most databases have some type of automation built in there.

That could be web crawlers that are going out and pulling images for you and bringing it right into your database. That could be sending letters out. So instead of sending a manual email out through Outlook, maybe you can send that letter straight through your database or sending verification letters, with the push of a button ultimately.

This also could be sharing information to other departments.

We mentioned payer enrolling. I had that set up because I was able to share the documents over to our payer enrollment department without her having to come to me.

Another great option there is also for your DOP, for all your approved privileges.

Instead of keeping some repository of your DOPs in your surgical suite, there is an option to have a privilege viewer, so they can see exactly what privileges have been approved for them.

This is also something that an entire organization can utilize.

My hospital was able to go in and actually see exactly who's been approved without having to come to me and ask, hey, who is this? They were very good at questioning any practitioner they were not aware of. So that's available for them as well to make sure that, these practitioners are who they say they are and that they're allowed to be there.

Removing that antiquated collection of all of those privileged forms, whether that be in a paper binder or maybe in a shared drive. It's just those are so hard to maintain. These databases create all this amazing automation and to simplify it for you. At the end of the day, it really does make your life just a little bit easier.

Measuring Process Improvements

And then after you created all of these amazing improvements to your process, you know, we can measure it with various metrics.

So, define what success means for your organization and have ways to assess and track it. So, you should be evaluating it before you make the improvement as well as after those updates. And typically, your turnaround time is going to be almost an immediate response. You can always ask feedback from your practitioners on the credentialing process as well. You know they will be honest with you of how well they were able to get through, the process, document collection, things of that nature. Get that feedback from them and use that to also make some improvement.

Continual improvement is absolutely needed in the process to ensure you're being most efficient, and then staying up to date with your industry standards is absolutely key.

 

And next, we are going to we have another poll question for you here.

We'll get that pulled up.

Question: What would help you be more successful in your role?

And this one, you may find to be a little difficult to pick one. So, select the options that best answers this question for you. So, you can select more than one here.

And we'll give it just a few more seconds.

And we had discussed this internally as well. So, well, all of them!

Right? That would make everybody's life a lot easier, if you had all of them. But, you know, sometimes you can only choose one to really focus in on and, you know, improve.

We still have a lot of voters coming in, so, give it just probably another ten seconds.

Al let's see. It looks like the vast majority said completed applications with no missing information. That would be great.

And better response rates from your practitioners.

All of these things are pretty close.

But it actually transitions very well into our next, topic of conversation which is building that strong relationship with your practitioners.

Building Strong Relationships with Practitioners

I actually spent several years working in Human Resources, so I truly knew the importance of having to build that strong relationship with our staff and with our employees.

And this really relates very well in the credentialing world as well.

So, let's move into some, you know, the reasoning and how you can help to build that relationship with your practitioner. I highly recommend starting that conversation, that relationship with them, early on. At the time that you know this new practitioner will be joining or applying for privileges, go ahead and reach out to them then. Give them, like, that overview of your credentialing process and explain why certain items will be required.

Our role is to ensure that they are well informed and that they can understand the information that we are requesting of them and understanding why it is that it is necessary for us.

We also want to provide clear communication.

This will, ensure that they are providing the required items which will in turn give us the information that we need quicker to be able to complete our job.

We also want to put ourselves in the practitioner's shoes, so certainly empathize with them. We go over this information day in, day in, day out. We're familiar with our process and why it's needed and why certain things have to go in a certain way, but they will not be familiar with that. I mean, each hospital kind of processes things a little bit different. So, we need to help them to understand that. We do have a very useful guide that you can utilize.

This is especially useful for new practitioners that have never been credentialed before and are totally new to this.

Also involve the practitioner through your credentialing process, and speaking from my previous role, this was especially helpful when it came to peer reference requests because we were not getting responses back from those peer references. So, involving the practitioner process go a lot smoother. You can work together with the practitioners to make it as seamless as possible, and they'll really appreciate it in the end.

This will make a stronger relationship during their tenure there at your hospital or your facility and they'll be willing to work with you again at a later date say when reappointment comes up.

If anybody is familiar with the any state mandated application, so I was in the state of Colorado, which no longer is state mandated, but it was at the time. And so, during that, you know, whenever they actually updated the application, when their reappointment came up, they needed to also utilize the updated version.

I'm sure you can all understand that those practitioners were not happy about having to fully complete a whole brand-new application all over again.

I worked with them. Most of them participated with, like, CAQH, where you can pull those state mandated applications from.

I was able to work with them to provide that step-by-step instruction and make it a little bit easier for them so they're not having to replicate that information again.

They very much appreciated that when they're, you know, worrying about the reappointment and collecting all of the information together after submitting it to us.

Yeah. And the fact that you are willing to assist them with that, again, sets up, starts to build on that relationship, they'll remember that. So, if you ever need something from them, it'll be easier to get that information.

I've, a lot of times, was scrambling to find a preceptor for a medical student and having built that good relationship with them from the initial start and assisting them with even the credentialing process, I could potentially reach out to them later. Hey. I need a preceptor. And they'd be willing to assist me with that situation because I was willing to assist them with the credentialing process.

Something you also want to keep in mind is if your particular facility has some additional steps, when it comes to onboarding, so your practitioner is credentialed. Do you have additional steps that need to happen on-site? Do you require an on-site orientation for some practitioners?

My previous hospital, we did. So being able to provide them with, a timeline, not just the credentialing piece, but then here's the additional steps that need to happen. When you get your ID badge, do you have to go through EMR training with IT? Do you have to meet with medical records? Those sorts of things.

Sometimes they were not as happy about having to come on-site because, again, not all hospitals make it smoother, make it quicker, so we're not tying them down when they could be taking care of patients.

And one of the things we did in our office, again, Amy and I worked together.

We had a really nice coffee bar for them. So I know you have to be here early in the morning for this couple hours for EMR training, orientation, but at least, you know, we try to provide them with, you know, some snacks, some coffee to kind of alleviate some of that burden as little what little we could do. But they were appreciative. They enjoyed our coffee bar. Absolutely.

Positioning as a Strategic Leader

So, positioning yourself as a strategic leader is absolutely crucial in the credentialing process.

It involves working together with leaders and the team, streamlining your processes and utilizing your resources effectively.

So many of you are aware, that the medical staff office is often the last to know about a new practitioner.

We can sometimes get a notification that this practitioner starting next week, or we have a welcome party tomorrow, and you have no idea.

I had this happen to me when I was on vacation scrolling through social media, and I see an advertisement about a brand-new practitioner who is literally beginning that Monday. So here I am on vacation sending an email to HR because they're an employee practitioner, the department director, my director, the CEO, everyone saying, hey. No. This person cannot start. They do not have privileges. They will not begin on Monday as stated.

You know, a lot of times we're sitting in these committee meetings, and I hear about a new practitioner who's coming into the hospital, or maybe somebody's talking about a new procedure that's going to be offered.

Now we all know that there's a certain process that all of this has to go through for all of these things to be approved.

You have to speak up and, make it known that this is not happening, and we do need to go through the appropriate, approval processes here. It is very important, to become involved with the discussions early on with your leaders and your C-suite.

The example of this new practitioner that I saw on social media actually led to us creating a physician onboarding meeting. If you don't already have one of those established, I highly suggest it. We had IT, HR, payer enrollment, risk, quality, medical staff office, our executive assistant who worked side by side with the CEO regarding contracts, and even medical records. This gave us a time to really discuss, okay, who we're working on, start dates of people, who's in the pipeline, and honestly, even if we heard rumors or an inkling of anything.

So, we were all very aware and on the same page of who could potentially come in, and so there were no surprises.

And through this, it honestly, everybody really funneled everything through the medical staff office. They were not afraid to just communicate to me personally.

IT also, they would not give a practitioner access unless the request came from the medical staff office.

It did not matter if you were employed or if even another director is asking. If the ticket was put in asking for a practitioner have access, he immediately sent me and educated that individual that they must all come through the medical staff office. So, it just to ensure that they were approved and have the appropriate privileges in place to gain the access into our hospital.

I was very vocal and helped spearhead those improvements. So, it is important as an MSP, to be very involved.

And from C-suite all the way down to, you know, our actual clinician, they all communicated into the medical staff office which really, assisted me in ensuring that the practitioners had what they needed.

You don't necessarily need the title of a vice president, or a director, or manager, even the title as coordinator. You can still insert yourself into decision making processes, software resources, updating your procedures, and the revision to your bylaws or policies and procedures.

 

You're the subject matter expert. So do your research. Bring your return on investment if an electronic database is really what you need. Maybe you need additional resources.

Provide that research, to whomever is needed to be included, so you can, you know, be successful in your role.

Recruiting and Retention Strategies

If the additional resources are something that is needed, recruiting a solid team is very important. So, you need to look for candidates who have a good understanding of the job, obviously fit well within not only your department, but within the hospital and your culture and have the necessary skills and knowledge.

Interviews can be very hard to gauge a person's abilities and their fit within your organization. But asking good probing questions, is pretty crucial.

My interview here at symplr was the first time I have actually been asked specific questions regarding basic verification, just to, you know, see where I am knowledge based. And then to this day, we still ask some very basic verification type questions, but it really helps us understand where the candidate is, and their learning process.

But maybe recruiting isn't in the cards for you necessarily right now, but resources are available, that are out there such as some temporary help, CDOs, etc. those type of elements are there if you need some immediate assistance and then they can assist with any backlog or, staying up to date with your current file.

And I would just mention for those that are in director or manager roles where you're doing more high level overseeing of your team and you're not in day in and day out processing the files themselves, it's important that you get feedback from your staff that is involved in processing the files. Bring them into the discussion if they aren’t already included. Don’t leave them out in the dark and then they're left with this, short time frame to try to get work done. Include them, put them into that process if not already.

Absolutely.

Q&A Session

So that actually brings us into, the Q and A.

But as a reminder, we do have a short survey again directly after the webinar closes, so we would, much appreciate if you could take a moment to fill that out for us because we very much value your opinion.

So, again, we will head off over to q and a.

We do have some questions in here.

What would you say is a major factor affecting staff retention in the medical staff office?

I think one of the things we highlighted in just in a couple slides ago was being able to recruit. So if you are in a position where you are recruiting new staff members, that being able to ask those knowledge based questions, to ensure that you're getting the right candidate in there, which will in turn ensure that you will be able to keep that candidate because it's someone that actually knows the work, knows what needs to be done, keep them engaged also. If you're not including them in some of those decision-making conversations just so that they can at least be in the know of what's going on, that can also affect the retention of keeping that person there.

Anything you want to add?

Yeah. I think, I mean, obviously, I've had experience in both the smaller and a larger hospital.

Being in a smaller hospital allowed for more interaction, and my opinions were valued. As a leader, including staff is crucial. I felt trusted and heard, which boosted staff engagement. This approach is important for all staff, not just medical professionals.

So, coming in with zero experience, you know, that it can be a lot of information thrown at you.

I know even with some of our newer staff coming here, in the CCO, I'm always like I always tell, I'm so sorry. This is going to be a lot of information coming at you.

Because not only are you learning potentially a new database, maybe multiple databases, where things are supposed to go, your policies, your processes.

And then on top of that, also learning standards and the actual necessary step of the credentialing process, it can be a lot!

So, I think, working with new hires on an appropriate kind of step by step on getting them there.

But it can be definitely a lot of information and definitely overwhelming.

Yeah. And there's some outside resources that you can utilize as well, you know, for training and brushing up on certain standards if you're not familiar with them.

Why do you think hospitals won't invest in credentialing?

That's a tough question, I will say.

Honestly, I also I personally feel, that they don't necessarily know. They don't know what goes into credentialing, and that is often where, kind of c suite might be a little I don't want to say lacking, but lacking that knowledge base on, you know, really the exhaustive list of things that we do. And, I mean, typically, a lot of us aren't just doing credentialing that, you know, maybe you might be wearing multiple hats, but that was my case that I was working all over the place. It wasn't just, the medical staff as well.

So, a lot of times it is really just knowledge of how much goes into it.

So, I think that's where it is very important being vocal about what is needed and providing that research to your leaders. So, you can show, okay. Well, this is what I can do, you know, to be more efficient. And then I mean, at the end of the day, though, do you want your practitioner saying quicker? Okay. Here's how you can help me do this.

They want them in as quick as possible because not only is it making the hospital money, but you also know, it's covering any potential gaps that are, you know, presented in the hospital as well as well.

What is your opinion on having the provider enrollment in the medical staff office?

I have seen both, I will say.

So, this is often an area where I know I talk to people and said, do you know the difference between them? Do you know the difference between provider enrollment and credentialing in the medical staff office? Because they are two very different processes. And I will tell you, I will never be someone that says I know provider enrollment.

Give me medical staff, give me credentialing. I got it. But, yeah, as far as the enrollment piece of it, that is not something that I am knowledgeable. And so, obviously, I'm going to go to my expert in that process. But, again, I do see it often especially in, I mean, it can be in larger organization.

Typically, I see that more of, like, you know, maybe somebody who oversees both processes, but they're still separate.

And yeah. I mean but, again, I personally worked side by side with my payer enrollment, specialist.

And, I mean, there was never an issue. I know we had talked about kind of, you know, your packet that you're sending out that I included some of the requests that she needed within my request as well.

So, it made it, you know, a little bit easier for the practitioner and all one request all at once.

So, I guess I don't necessarily have an opinion on if they're combined, but I think it's important to really work together.

Because, again, we do it here as well that we do have a peer enrollment department. And so, we have to work with them and share some of our documents and data over. Obviously, not everything because there is stuff that is protected and shouldn't be shared.

But absolutely, I mean, want to work side by side and make it easier for the practitioner, so it's not so confusing because it definitely can be.

Yep. So, pros and cons to both sides of that.

What time of year do you anticipate an increase in applications?

I know we certainly see an uptake during the summer.

Yeah. Summer is typically kind of the biggest areas because of our residents completing their program.

It, honestly, it would depend.

I was in an area that was a tourist area that had, a high higher population during the summer months and the winter months. So that was when we've seen increase in population. We see an increase in patients coming into our hospital. And typically, when we see, you know, we need more practitioners to assist.

But I think majority of the time in the summer months for the most part, I feel.

When you said the MPDV can be used for OIG, Sam, Medicare opt out rather than running directly from those sources. Do you run them on a month, or you run a monthly status report to show enrolled or are you using continuous query?

I guess if you do have continuous query for MPDB.

for our customers, we have both options.

For our continuous curriculums, some of them just want us to run just MPD, and that's all they really care about. And that's honestly what I did, and my organization was I just used MPDV as, the verification.

You get your notification within twenty-four hours once that report is on there, so you will know. It will be right there.

But, if you don't have MPDV, then, yes. You would need to run all of those individually. But as far as the enrollment, you do enroll them in continuous query. So, it's either a onetime run or it's enrolled in continuous query.

We have physicians that will tell us that they have been practicing for so many numbers of years and have never been asked for some of the things that we're asking of them, such as a recently attested CAQH. Do you have advice for how to respond to them?

For positions that are saying, basically, no one's ever asked me for this information, and now you're asking me for it, you know, advice on, like, specific to, like, the CAQH.

Some organizations they have to have specific, PPOs with CAQH to be able to pull those applications.

And so, providing the password and logging in for them, I would highly suggest you don't do that. I would give them the step-by-step instructions, to be able to pull that application if you accept it.

The biggest thing when I was in Colorado, we could pull CAQH, and it was on the state mandated app that we were using.

If you are using your own internal application, then, unfortunately, obviously, you can't use CAQH.

A lot of times, the applications that you have, not only include additional information that CAQH doesn't ask because remember this that is very peer driven.

So, there might be potential additional attestation questions that might that you might require within your organization.

At the end of the day, your medical staff approved that application.

So, if they did not approve the use of CAQH, then no. We cannot use the CAQH app.

Remind them of the timeline because that that comes into play. Why you're asking for the reattested is because of your timeline, you know, when it was last attested.

Is it now too old? So just remind them of that as well.