5 Things that Slow Down your Credentialing Process

5 Things that Slow Down your Credentialing Process

Oct 1, 2019
  • Author:
    Noelle Abarelli

Please raise your hand if you feel like your credentialing process is a bit like applying for a new home loan!

When you start the home loan process you are hit with filling out a lengthy application with all your personal information since birth, having to verify your employment history, outstanding debts, provide copies of your bank statements, past tax filings, obtain a credit report, give a blood sample (not, but it feels that way) and more, killing any excitement you had about your potential new home. As a new home buyer its daunting enough to have to gather all this information – never mind knowing that your loan can take upwards of 45 days to process regardless of your good history and credit score, and you could be denied by an underwriter.

Well there is good news! Physician credentialing doesn’t have to be as daunting as the home loan process. With the right tools at your disposal you can quickly and easily finalize all the required data and approvals all without delays. Download our Ultimate Guide to Paperless Credentialing, to discover opportunities to expedite provider credentialing while we will walk you through 5 things to avoid. Here we go.

#1 Hard Copy Applications

Different from applying for a home loan, credentialing applications should be done online, not on paper. An online application will accelerate your operations, ensure accuracy and completeness, reduce errors, and requests for missing information. Eliminate time-consuming data entry with a secure portal to collect provider information, the ability to download the information directly to your database and automated data checks to assure complete and accurate data. An online application process will reduce the time it takes to get back applications during your biannual re-credentialing. Speaking of re-credentialing, the ability to pre-populate online applications with current provider data will improve response time and increase provider satisfaction.

#2 Inefficient Provider and Interdepartmental Communications

Another area that can delay the credentialing process is communicating with providers as to what their tasks are and how to complete them. One way to avoid delays in communication and time to complete tasks is to utilize a provider portal. A provider portal is a one-stop dashboard for a provider to view and act upon their multiple tasks through a smart phone, tablet or laptop. A portal enables providers to quickly view and manage all their information.

Full onboarding of providers includes interactions with different departments, not just credentialing. HR, IT, Marketing, Clinical, Scheduling and others all have tasks that are associated with getting the provider up and running and seeing patients. Being able to centralize communication with all of these departments will make the onboarding process more efficient. Facilitating interdepartmental communications with a system whereby each department can view workflows and quickly manage their respective onboarding steps will accelerate the entire onboarding process.

#3 Manually Verifying Data from Primary Data Sources

There are many credentialing data sources that need to be verified including licensing, state boards, NPDB, DEA, provider affiliations and more. Contacting each of these sources manually even with an email can be a slow process, especially waiting for a response. Why not access these sites automatically, query each site for the desired information and have the results returned to you almost immediately? Not only do you have to verify licensing and certifications, but you also have to check for sanctions, exclusions and disciplinary actions on your providers. Integrating with all of these sites automatically will prevent major delays in data acquisition and significantly decrease your credentialing completion time.

#4 Manually Tracking Privileging and Peer Review Activities

Are your department chairs reviewing a manila folder full of credentialing papers? How much time does this take and how fast can they get this done with their busy schedules? What if you had an automated process to electronically assess the provider, review the initial and re-credentialing provider data, grant or comment on clinical privileges, and take immediate action on the file. How much time would that save?

Just like with provider assessment, peer review can be a lengthy process if one is required to physically write a report on every case. Why not provide a customizable form to track performance indicators? Online tracking mechanisms provide timely and more effective closure to open reviews, improve patient safety through the automatic generation of reviews, eliminate manual form errors by allowing for required fields, provide selection criteria and improve communication among participants of the peer review process, reviewers and the Quality Department.

#5 Not Proactively Tracking and Monitoring Appropriate Performance Measures

The Joint Commission requires hospitals to set OPPE standards. The value of OPPE depends on the measures selected by the medical staff, how well those measures represent activities that reflect the quality of care and performance, and how effectively the resulting information is used. Utilizing an online dashboard where all main performance indicators can be viewed is key to having visibility to the level of performance of your staff. Such a dashboard can be used to automatically track patient data such as admissions, mortality, and average length of stay, which can be used to address delivery of optimal care, and safeguard ongoing reimbursements. Collected data can be utilized to measure your practitioners against industry standards on the national, state and enterprise levels. Organizations that provide ongoing computerized access to data have found that practitioners will look at their own data and proactively implement changes to their practices especially when they are shown data that they are not performing to the same level as their peers.