Thou Shalt Not Withhold Efficient Credentialing: Bylaws Are NOT Written In Stone

Thou Shalt Not Withhold Efficient Credentialing: Bylaws Are NOT Written In Stone

Sep 12, 2018
  • Author:
    Angela Beardsley, BSBA-IT, CPMSM, CPCS
    Senior Consultant
    Angela provides consulting services on best practices for implementing CredentialStream Clinical Solutions, including Privilege, Performance Metrics (for Professional Practice Evaluation) and Case Review. She has almost 30 years of experience as a Medical Services Professional (MSP), with almost 5 years of Consulting experience, and nearly 25 years prior experience in MSP leadership roles, both in the Hospital and Ambulatory Post-Acute settings.

Bylaws are still taking the blame for Medical Staff Offices not being able to influence more efficient credentialing processes. Many Medical Services Professionals (MSPs) continue to overextend themselves to produce verifications that are neither required by any regulatory agency nor adding any value for credentialing decisions. When asked, MSPs state the reason for this is, their Bylaws require it.

In today’s health care environment, revenue is under high scrutiny and Executive Leadership is demanding quicker turnaround times for credentialing and provider enrollment, to maximize timely reimbursement from payers. It is more important now than ever for MSPs to partner with a physician champion who can support enabling Bylaws changes, when Bylaws requirements are preventing an efficient credentialing process.

Fellow MSPs, Bylaws are not written in stone, they CAN be changed! If your Bylaws are the reason you are still going back 10-20 years when verifying work history, hospital affiliations, and/or malpractice history, please do yourself and all the key players in your organization’s onboarding process a huge favor. Find a physician champion to go to your Bylaws Committee with you, along with the supporting regulatory standards and also any directives from your Executive leadership, and advocate for these changes.

Bylaws changes can be easier than you might imagine. As MSPs, we are always feeling the pressure of timely credentialing and onboarding, our Department Chairs need a new practitioner to start yesterday, so why would they not want to support you in obtaining approval of amendments that are necessary for a more efficient credentialing process. It is likely that Department Chairs or other physician leaders may not even realize there is outdated language not required by any regulatory agency in the Bylaws, which is preventing a timely credentialing process. Just having a conversation, and educating them on the standards is all it may take.

Bylaws are a living document that must evolve at the same pace that regulatory standards and our health care environment evolves, as they contribute to ensuring that the most efficient processes are in place within our organizations. As MSPs, we can be proud that we have the opportunity to help facilitate Bylaws changes and make a difference within our organizations. By eliminating Bylaws language which calls for verifications that are not required and/or do not add value, your credentialing process can be reduced by several days to several weeks, and contribute to your organization’s goal of more timely turnaround.