This year’s NAMSS convention was extra special for us because it took place here in our hometown city of Philadelphia. And, it was wonderful to see so many customers and colleagues in person. We had tons of fun with our roving prize patrols and custom pins. We also showcased our integration with symplr’s Cactus Provider Management Platform and shared news about our integration with symplr’s IntelliCredTM credentialing software suite.
“One of the best things about the conference was meeting one of our customers face-to-face for the first time and hearing that our digital peer referencing solution is a ‘game-changer.’” said Kris Wenner, product manager at SkillSurvey. According to Kris, the customer advised, “I had two references complete their forms in just one day… that has never happened in all my life of credentialing!”
Another attendee explained how she was eager to see a demo after her Chief Medical Officer completed a digital peer reference form as a reference and sent a screenshot advising “We need to get this!” Note, if you’re trying to get support for an initiative in your organization, you can send your CMO or anyone else this online sample peer reference experience.
Credentialing for excellence
“The sessions were a good opportunity to gain first-hand knowledge of the real situations that credentialing teams confront,” said Kris. One of the most interesting for her was the “Credentialing for Excellence” interactive workshop that focused on developing policies, best practices and bylaws. Participants reviewed sample applications and had discussions around potential red flags and how new policies could help to address them.
“This is where SkillSurvey Credential OnDemand® can really help Medical Staff Services teams by automatically setting red flags for missing information or when responses do not meet their policies or other criteria,” said Kris. Another area that was discussed was the problem that often occurs with hand-written form responses that seem like the responder simply “went through the motions” and checked all the boxes as “good” but did not provide any comments. “SkillSurvey’s digital forms can be set to require that all fields — including comments — are answered. This ensures that no questions are skipped and that teams have more quality information for their review.”
Linda Van Winkle, SkillSurvey’s credentialing consultant based in Lake Charles, Louisiana, attended the virtual NAMSS sessions. Here are some of the top tips and take-aways she has:
Session: Things That Scare Us … About Your Medical Staff Bylaws
Medical Staff documents should be consistent among hospitals in a health system. If a plaintiff’s attorney sees that a physician became a member and was granted privileges at multiple hospitals with different qualifications, different corrective action procedures, etc., this opens the door for negligent credentialing claims. For example, a summary suspension at one system hospital should apply to all hospitals within the system.
“When you’re acquiring a new hospital, make sure you review the bylaws and make sure they’re in alignment with other system hospital bylaws,” says Linda.
Another tip she learned: your baseline qualifications for Medical Staff should not use the word “unrestricted” as in “Holds a current, valid, unrestricted license to practice his/her profession in the State of _____. Don’t use the word “unrestricted” because it eliminates a lot of physicians. Take out the word “unrestricted”.
The Provisional medical staff status should be eliminated. It is no longer needed as all new members are subject to FPPE and, thereafter, OPPE.
Session: Transforming the Medical Staff Office in a LEAN Process Improvement Environment
The worst phrase ever for maintaining the status quo is “That’s the way we’ve always done it.” This mindset leads to non-innovation; stagnation; and, failure.
“Making the change to new digital tools may seem daunting or too much change to your current process,” says Linda. “However, as this session shows, there can be tremendous benefits to automating and using digital technology. And, our team can make it easy for you and guide you every step of the way with best practices.”
Are there elements to your credentialing process that waste time and resources?
- Are you still mailing and faxing forms? This is non-value added time.
- Are you credentialing provider types that don’t need to be credentialed? For example, provider types not required to be credentialed by CMS or accrediting bodies? Does it add value? Are you doing it just because you’ve always done it that way?
- Are you hand-delivering files to be signed by department chairs, etc.? Consider electronic signature; it saves team time and isn’t expensive.
- Are you asking for affiliation verifications all the way back to medical school? Does this add any value? Consider shortening the time frame (e.g., affiliations over the past 5-10 years).
- Are you “Batching” your work? It often results in longer turnaround time than a continuous flow process.
Session: Enrollment and Credentialing: The Integration Opportunity
Every day that is wasted in the onboarding process for one physician costs several thousand dollars, making a huge impact to the bottom line. If you could cut out just one day, one week, in the process, it would make a significant impact.
- Utilizing skilled credentialing staff in the payer enrollment process.
- Utilizing one practitioner database as “source of truth” vs. having a database for credentialing and another database for enrollment.
- Eliminating duplicative processes (data entry; expirables; reaching out to providers). Physicians complain that they are being contacted by different departments in the hospital for the same information/documentation. (Note, this is one area where using SkillSurvey Reference® for hiring and SkillSurvey Credential OnDemand® can help by integrating reference/peer reference requests.)
- Limiting handoffs between multiple teams
- A comprehensive single application packet that encompasses both credentialing and enrollment needs allows single follow-up with providers.
- Track enrollment TA times for your payers. We can only control the first part of the process; we can’t control how long it takes for the payers to turn the enrollment around.
One example from the session was that a mid-size community health system achieved 100% enrollment of all practitioners by start dates!
Session: Single Source of Truth: Is It Enough?
Although verification of hospital affiliation is not required by any accrediting or regulatory bodies, it is an industry practice. Consider how far back you want to go (e.g., 5 years, 10 years) in verifying affiliations and identify the time frame in your policies and procedures.
“One option we learned is to verify more affiliations if there are any flags or NPDB reports,” said Linda.
Session: National Practitioner Databank Guidebook Update
The latest edition of the guidebook was published in 2018. The NPDB will give you a written response to any questions you have about the NPDB Guidebook! They are very good at reading and responding to your questions.
There is a $38,159 penalty for failure to report final adverse action against a provider, supplier, or practitioner. And 3-year loss of immunity.
Closing out a great conference
This jam-packed conference was a lot of information to cover! The education sessions and our many discussions with attendees provided an opportunity to expand our knowledge of current issues and trends medical staff services teams face and will help guide our future product development. If you’d like to see how SkillSurvey Credential OnDemand can help you manage all the fast-moving changes in the world of credentialing, attend one of our monthly webinars.