Practitioner Centric
Credentialing
(or you might call it Onboarding)
Renee Aird Dengler, RN, MS, CPMSM, CPCS
February 11, 2016
Credentialing Takes Too Long!
IMPROVEMENTS OVER THE YEARS
Health System CVO
Data and Credentialing Standardization
Paper-Lite
Electronic Applications
Electronic Privileges
Keeping Up With Changes in
Health Care
Telemedicine (it’s not just for radiology anymore!)
Hospitalists
Mid-Level Practitioners
Employed Practitioners
ACOs
OSAs
It’s better, but it’s not good
enough!
How do we know?
It still “takes too long” and no one is happy!
“It’s the medical staff office”
“It’s the CVO”
“The practitioners don’t fill out the application completely”
“Recruitment has unrealistic start times”
“It’s contracting” –” it’s the practice manager” – “it’s (fill in
the blank)”
Tired of redundancy and rework and complaints.
Changing the Way We See
Things!
Department / Service Credentialing
Duplicative, Redundant
Practitioner “Credentialed / Privileged” Multiple Times
Time and Labor Intensive
Not Associate Friendly
Not Practitioner Friendly
Current Site-Centric Application Process – The Voice of
the Customer
“I had to be credentialed with ___ and ___ at the same time. They never seemed to be on
the same page and often times the information requested was redundant and this made the
process very tedious. Every day someone was asking for something another person asked
for the day before. This process is very inefficient. They need to work together to make this
process easier for the physicians.”
“I feel the whole credentialing process was extremely confusing. Different people told me
different things were needed and I wasted a lot of unneeded time. At some points, I don’t
even know if the people working the process knew the proper process.”
“Better coordination between different credentialing authority. I have to talk to three different
people for the same paper work. I’d rather prefer one person take care of the credentialing
process and tell me what they need from me.”
“The process took way longer (months) than it should have due to very poor communication
and feedback from the staff as to what was needed, etc.”
Source: New Physician Applicant Survey Comments
Changing the Way We See
Things!
Voice of the Customer
Practitioner Centric Credentialing
Business Redesign
No Shortcuts, No Workarounds
Purpose
Process redesign whereby all
applicants have one port of entry with
a navigator to coordinate the
credentialing process across all sites.
Current Process (in a nutshell)
One Port of Entry
Navigators
One Application, One Set of Documents, Share
Source of Truth Database
Applicant Directory
Practitioner Centric Reappointment
Benefits of a Practitioner
Centric Model
Standardize processes
Consistent data entry
Eliminate duplicative activities
Reduce rework & minimize reconciliation
Perform activities when it makes the most sense
Combine related activities
Minimize hand-offs
Benefits of a Practitioner
Centric Model
Improve service experience for new practitioner
Improve service experience for practitioners at
reappointment/ recredentialing
Eliminate barriers
Cost and labor savings
Revenue!
Participants (a lot of them!)
Recruitment
Business Development
Contracting
Legal
Risk (Malpractice Insurance)
Physicians
Marketing
Practice Managers
Hospital MSOs
Public Relations
Service Line Leaders
Network / Payer Enrollment
Etc.
QUESTIONS!