Provider Credentialing: Reducing the Burden for Providers and Credentialing Staff

“Could you please find my medical school diploma?” This request, made every time I join a new healthcare organization, has become a running joke with my wife. I, like many healthcare providers, still store my paper credentials in a box under my bed. After practicing medicine for 30 years, I’m not talking about a small shoe box. My credentials box is a banker’s box that holds a staggering number of paper records, including my medical school diploma, state medical license, DEA license, curriculum vitae (CV), letters of recommendation, case logs—and many more documents.

Kestner DiplomaEvery time I need to be credentialed at a new healthcare organization, I call my wife and have her dig through the box under my bed to find something I need to provide to the new organization. I’ve been repeating this process for almost 30 years and in 6 states and 9 health systems. This process is very frustrating to providers, who already deal with more paperwork than they expected when they started medical school.

Paper credentials are just one piece of the manual provider credentialing and enrollment processes that many healthcare organizations still engage in. Providers complete and sign hard copies of application forms that must be sent to payers. Providers working in a healthcare organization that covers a tri-state area need to be credentialed in all three states and have privileges in multiple facilities. The states may have different credentialing requirements and re-credentialing timeframes, so there’s a lot of information to track, requests to respond to, and documents to share.

Hospital privileging and payer credentialing can take up to six months – incomplete or inaccurate information regarding a provider’s professional certifications, work history or malpractice insurance can lead to extensive delays causing member access issues and lost revenue. That manual credentialing process, with its heavy administrative burden for providers and medical staffing departments, isn’t efficient or sustainable. Providers, who have to prove themselves every time they join a new healthcare organization, need an easier way to manage their professional identity and complete the credentialing process. Your credentialing staff also need more efficient methods.

If your credentialing staff is manually tracking down provider credentials in the verification process, it is time for them to stop working so hard. The best way to simplify their job is to automate and digitize the credentialing process. Provider credentialing software allows you to send providers a digital credentialing application, which launches an electronic, paperless verification process. Effective credentialing software eliminates redundant manual data entry and automates data transfer between various sources, reducing errors and expediting the process 

TractManager’s technology-enabled Provider Credentialing solution streamlines and automates credentialing, accelerating the process and reducing the administrative burden on providers and medical staffing departments. We also provide a digital “data lockbox” for providers so they can easily transport their professional identity information when they move to another facility or healthcare system. They will no longer need to dig out that credentials box under their bed.

To learn more about TractManager’s Credentialing Solution, download our new white paper titled “To Delegate or Not to Delegate Credentialing.”

Author:

Mark S. Kestner, MD, MBA

Chief Medical Officer

Mark is a surgeon with deep leadership experience in military, university, integrated delivery, and especially community-based healthcare systems.

 

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To Delegate or Not to Delegate – That is the Credentialing Question

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