A blog for medical professionals and physician group practices to learn about and share experiences associated with provider credentialing, privileging, enrollment and analytics.
When provider data reside in multiple databases and physical locations, health systems risk revenue loss, data inaccuracy, and provider frustration. At its heart, consolidation of...
Excessive paperwork, slow validation, and reimbursements in jeopardy are common occurrences in outdated verification and credentialing processes. Learn more about how pre-formatted...
Electronic meetings can be an incredibly efficient way to conduct healthcare/medical staff organization business. But the “devil” is in the details (as usual). There are many...
OIG oversight of HHS programs ensures integrity, effectiveness, and efficiency. This can also lead to recovery in billions of dollars in savings. However the time-consuming and...
Without industry standards on defining credentialing metrics, there is no way to benchmark your organization with others. Standardizing six metrics in your organization can help...
It is NAMSS Week! This is the time to reflect on the medical services profession, and our collective accomplishments as well as our individual accomplishments....
If you have ever requested staff, equipment or other resources and been turned down maybe a cost-benefit analysis could have made the difference. Learn what it is what and what...
This is the first article in a series on remote working and shares four benefits to offering this work arrangement to credentialing staff....
Learn why fostering engagement in your team is important and three tips on how to do it....
Short client stories describing enrollment challenges they faced that proved both costly in time and money....
Approximately 200 organizations are currently recognized in credentialing by NCQA either as a certified CVO or under NCQA’s CR standards. Preparing for any type of...
The benefits of delegated credentialing from a medical group practice’s perspective are many. First and foremost, with delegated credentialing you can eliminate weeks from the...
Just because you use PECOS and enroll your providers electronically doesn't mean you shouldn't be vigilant of some key mistakes you could be making that could have an impact on...
Recap of the 42nd NAMSS Conference by former NAMSS President and CVO Symposium speaker, Vicki Searcy. ...
CVOs across the country are collaborating in effort to identify standards and lead the industry....
Ready to tune up and speed up your payer credentialing process? Here are 10 questions to ask before you choose a solution....
46.9% of credentialing professionals use PECOS for CMS enrollment. Save your organization and yourself time and effort by following these helpful tips to make your PECOS enrollment...
Is your organization prepared to prevent a provider impersonator? Recent news reveals why policies should be reviewed and four ideas to consider....
The issue of aging providers has been dealt with by some healthcare organizations – and organizations who have done so will attest that it isn’t easy or quick to determine how to...
Using PECOS (the Provider Electronic Chain, and Ownership System), Medicare’s online enrollment system to enroll your providers create efficiencies for your organization and can...
Provider directories are commonly overlooked assets of a health organization that can have a significant impact on physician satisfaction. Learn how you can improve your...
Take a look at 5 of the 10 findings described in the 2018 Annual Report on Medical Staff Credentialing that compare results from our 2017 report and takes a look into the future of...
Bylaws shouldn't hold your organization back from efficient credentialing processes. Here are a few tips to keep in mind when looking at Bylaw requirements....
Professional conferences provide great opportunities to learn from your peers. Here are some common trends that we found to have perpetuated throughout our user group conferences...
Medical staff professionals wear many hats and handle a multitude of projects. Is your staff prepared to juggle multiple cases and perform efficiently? Learn why project management...
You can never be too prepared! Disaster can strike at any moment and it is important that your entire workforce is prepared for what will happen next....
To secure additional resources, a credentialing department must create a value proposition based on accurate data converted to information. That information should tell a story...
Mergers and acquisitions are hard on staff. However that should be no excuse to let dysfunctions seep into your teams. Building a cohesive team from the start will lend itself well...
How many of us have learned things the hard way? I know that I certainly have from time to time. Save yourself a lot of embarrassment by making sure that new technology is...
There are thirty-seven different versions of your neighboring city’s hospital in your Hospitals Table staring at you right now. Which one do you choose? And how can you remove this...
We are in the middle of a busy conference season for medical staff professionals. While many of you have made plans to attend at least one event, there is another group who has...
Rachel Deming Purcell, Director of Regional Credentialing, Quality and Operations Support at The Permanente Medical Group sees that today’s positions now require systems thinkers,...
We at Verity love helping our customers! We enjoy the conversation, getting to improve our product from our customer’s recommendations and helping to grow the use of systems. ...
In my opinion, a credentialing (or a mortgage) process is electronic only if it is paperless for both the applicant and the recipient of the data. Your process is NOT electronic if...
Credentialing used to be solely focused on just that, credentialing. With all the changes our industry is enduring, it has become essential for healthcare organizations to...
Industry best practice is to make information about providers' granted privileges readily available to patient care providers (i.e., nursing stations, OR scheduling, pharmacy,...
The Joint Commission announced the requirement for OPPE in 2007, in order to give organizations time to formulate their strategies for compliance by January 1, 2008 (the date on...
With quality in mind, The Center for Medicare and Medicaid Services (CMS) launched their Hospital Value-based Purchasing (HVBP) Program in order to set performance standards and...
In most hospitals, the medical staff organization is supported by one or more medical staff professionals (MSPs). These individuals may be called by different titles, but their key...
I started working in Medical Staff Services in January of 2009, just one month before the HITECH Act was signed into law. At the time, meaningful use of health care data and...
File and folder organization can hinder or help efficiency depending on how an organization sets up their naming conventions. Commonly an organization will assign files to a user:...
Ann Klinger began her career in medical staff services in 1998 at Tuality Community Hospital in Hillsboro, Oregon. Prior to entering the world of medical staff services, Ann worked...
A standard master provider ID across the system ensures that applications that share data will always update information as desired. As applications merge and change, industry...
Advances in applications, technology and industry, provide more usage of automation tools. Impediments to taking advantage of these features occur when the data stored in the...
In order for databases to run at optimal performance standards, the system must have adequate space available for software being employed. Having unnecessary files or bloated files...
Record types are commonly used by a system to categorize data within an area. When large quantities of record types occur; data entry, managing and reporting becomes very...
Having an accurate Master Provider Database is essential for any healthcare organization. Over time it is easy to see how duplicate provider information occurs....
Duplication within large master reference tables can translate very quickly into data duplication with data containing the same information but with subtle but impactful...
One of the changes that I see coming is centralization of the decision-making process in health systems. What does this mean? In some organizations, the support for the...
In the 2017 Annual Report on Medical Staff Credentialing, 90.5% of you indicated that data management is an initiative that is extremely or very important, and 72.9% of you have...
Carefully selected metrics for your organization’s onboarding provider dashboard can improve workflow efficiencies, give insight into data, and improve reimbursements....
At a time when organizations are merging their systems and procedures, provider database standardization is more important than ever to ensure data integrity and reimbursement. ...
Standardizing and automating your organization’s onboarding processes can save time and money by accelerating reimbursements and narrowing the timeframe it takes to onboard a...
Perhaps some apply, and some don’t, and this is by no means an exhaustive list. But we think it’s always valuable to be aware of and examine mindsets (conscious and subconscious)...
Sometimes it feels as if we are not in control of our time and that contributes to the stress that we experience on a daily basis. One of the things that I’ve found that helps:...
If write-in privileges are permitted, that is a direct “flag” to surveyors of regulatory/accreditation organizations of the potential that privileges were granted outside of the...
Over 70% of last year’s credentialing survey respondents indicated their credentialing solution is the single source of truth within their organization. One of the downstream...
There were many very informative sessions such as Evolution in Competence Assessment Programs to Meet Emerging Trends in Licensure and Credentialing, credentialing portability and...
The report was published on May 2, 2018 and is the result of a survey conducted of Medical Services Professionals and others responsible for credentialing during December 2017 and...
Congratulations to the NAMSS committees and individuals responsible for making the arrangements for this conference – I know that those who were able to attend greatly benefited...
Highlights of the conference include changes in how the MAC will communicate with providers, changes to the Program Integrity Manual, MACS not requesting certain documents, changes...
Today's MSPs have worked very hard to streamline processes, both in technology and human ways. According to our research, approximately 80% feel they have streamlined and reduced...
Organizations are bringing together their credentialing, payer enrollment and recruitment teams to ensure data elements are defined to meet each collaborating partner’s business...
If you are looking to implement an electronic credentials review process as a goal for the next quarter or year, there are components that can be taken early to lay the foundation...
Before taking the plunge and shredding the paper, here are a few things you should consider to prepare your organization for success...
Discover the strategies that will extend the benefits of your privileging program to the point of service to ensure that benefits from your privileging program are realized....
Succession management is the process of identifying those jobs considered to be at the core of the organization – too critical to be left vacant or filled by any but the best...
All of us who work in healthcare have seen and experienced the many changes that have occurred as a result of the shift of organizations to increasingly employ/contract with...
