Credentialing in 2020 - Future Planning

Credentialing in 2020 - Future Planning

Jan 6, 2020
  • Author:
    Vicki Searcy
    Former VP, Consulting
    Vicki has managed several credentialing and privileging practices, led a national healthcare accreditation and compliance consulting practice, was a surveyor for the NCQA, and a former president of NAMSS.

Everything seems achievable when you start off a brand new year. Possibilities must abound – or we wouldn’t make New Year’s resolutions, and buy exercise equipment and join Weight Watchers to assure that we keep our resolutions! (As I write this, my new stationary bike is on its way – bets are being placed by my family and friends as to how much it will be used! Stay tuned…)

A few weeks ago, at a VerityStream consultant’s meeting, we got into a conversation of what credentialing-related things we would change if we had the power to immediately do so. Here is what is on our wish list for 2020:

  1. Standardized payer rosters – wouldn’t it be great if payers agreed on the data that they want and the format? Life would be much smoother sailing for those who work in enrollment if we could make this happen.
  2. National licensure for all providers – I actually don’t anticipate that this will occur, but why, why, why does each State have to have its own licensing process??? And – they are all different. Some are very manual and others more electronic. Think how much easier it would be to facilitate telemedicine services!
  3. Standardized national application – this has been proposed for years, but it hasn’t happened yet. What we do have is an array of applications, some of which are mandated to be used by certain states, some of which are available but optional and other states do not have any. When a provider lives in a border area, he/she must complete different applications, etc. not only for licensure but for hospital and other affiliations! A national application used by all would eliminate much duplicative work.

So – the above is a short list, but would have a powerful impact on the individuals who work in the credentialing and enrollment industry, as well as the providers who must apply for multiple state licenses and complete multiple applications for various health systems and payers. While we can’t wave a magic wand and make this happen, VerityStream consulting services will continue to support initiatives that eliminate unnecessary and duplicative work.

Thanks for reading – and I hope that your wish list for 2020 comes true.

Happy New Year to each of you!