The Urgency for Accurate Execution Amongst Medical Service Professionals

The Urgency for Accurate Execution Amongst Medical Service Professionals

Dec 28, 2021
  • Author:
    Thomas Heitz, CPCS
    Clinical Solutions Consultant
    During his time as a Medical Service Professional, Tom gained proficiency in various processes including onboarding, credentialing, privileging, quality (OPPE/FPPE), accreditation standards and medical staff management in both independent and unified facilities. Tom now uses this deep base of knowledge to consult VerityStream clients during their CredentialStream implementations.

As Medical Services Professionals (MSP), the heart of our jobs, whether we realize it or not, is about execution. Execution is not only about delivering actionable progress, but accurate results. As the role of the MSP has changed and grown over the years, MSP’s have come to be viewed as gatekeepers of patient safety. This is true, in part, because MSP’s don’t stop until they have turned over every stone and have complete confidence in the accuracy of our results. If we are being honest, some of us will not stop even when we are asked! How many times have you thought to yourself, “but if I only had another day, I KNOW I could get that final verification?” However, in today’s world, MSP’s find themselves being asked to deliver a lot more than accurate and complete files to the Credentials Committee.

As the role of the MSP has changed, so has the number of people who have access to our credentialing software, and privacy concerns are now a key consideration. As a result, MSP’s are now entrusted to protect the privacy of our providers personal and professional information in addition to enforcing data governance in terms of what is in our systems, how it is stored, and who can access it. Gone are the days where a single IT request could grant you access. With less people able to access the credentialing software, MSP’s are frequently asked to provide a variety of reports for a host of departments. These requests always seem easy on the surface. I know I’ve been guilty of saying, “no problem!” before really investigating if that information is something I could easily export from the system. If nothing else, we as MSP’s know the data is in our system, so there must be a way to extract it, right? In my work assisting clients we often spend time discussing what exactly said department is asking for. What do they want versus what do they need? Is this appropriate data for them to request? Is there a legitimate business need? Are they asking for this information, or are we just providing it because the person before us did? All these questions need to be considered when deciding how to respond to a request.

It goes unsaid that it is vitally important for this information to be accurate. Let’s look at some examples:

  • Information Technology: Your IT department needs basic provider information which includes National Provider Identifier (NPI), state license, DEA, etc. IT in turn is feeding that information into your Electronic Medical Record (EMR). Imagine the cascading impact if the NPI was off by a cell in your output and not matched to the correct provider. What happens if it is blank and that results in the NPI being removed from your EMR? The downstream impact of incorrect data could now have a direct impact on your providers’ ability to provide patient care within your facility.
  • Enrollment: The rosters running out of your software that go to your enrollment team are used to credential providers with the insurance companies. Errors within these rosters could delay your facilities ability to bill for the services your providers are providing.
  • Marketing: Often your marketing department requests information on providers that is used to invite providers to events or to update your organization’s website. Missing or incorrect information could potentially impact the information on the website that patients use to find and select providers.
  • Accreditation Surveys: If a surveyor asks for a report and you quickly run one without thoroughly vetting it, you could present a report that includes erroneous information. As a result, you could quickly find yourself in the hot seat!

These are just a few examples that demonstrate why it is important that the information you present to outside departments is accurate. The quote below speaks to the importance of both knowing what we need to do and following through to execute it.

“To me, ideas are worth nothing unless executed. They are just a multiplier. Execution is worth millions.” – Steve Jobs

At the end of the day, you can have a great idea regarding how to improve your reporting, initial or reappoint credentialing process or the appoint process. However, if you can’t execute your vision, your ideas cannot help anyone. As we head into 2022, I challenge every MSP to identify one thing they can improve and make it happen. It doesn’t have to be something big! Did you just move to a new credentialing platform? Try automating a task that you currently need to manually complete. Is there a report that has been on your to do list for months? Take a few minutes each day to search for one variable versus trying to carve out time to complete the report all at once. It is important to remember that your progress doesn’t have to come at one time; slow and steady is fine. We would never expect a coordinator to credential a provider in a few hours (Editor’s note: Well – not today, but who knows what might be expected and achievable in the future?).

We know that getting something done quickly is rarely the same as getting something done correctly. Rome was not built in a day and neither are your credentialing and reporting processes. However, over time and with consistent progress delivering the most accurate results possible, I know we can all achieve great things in the coming year.