Make the most of technology to streamline physician credentialing

By Charlotte Warburton, V2V Transformationist

Years ago when V2V Founder Irv Barnett and I first started working together, physician credentialing was a completely paper-driven process. Many physician practices have been slow to adapt to the new business of health care. Yet, by reducing redundant workflows, the need for expensive storage space, and the risk of security breach, transformation of formerly paper-based systems only furthers the sustainable success of your practice.

While typing and printing out multiple forms with the same physician information, we heard about an automated process for credentialing-that could input and store detail, by provider. Wow! Our minds reeled with the possibilities of only entering provider data, one time, to populate many forms. Knowing this tedious process all too well and how easy it was to make errors, needless to say, we were excited.

Sounds perfect, but wait…

While supporting a specialty medical practice, we heard they just installed this type of system. When we arrived to begin our credentialing work, we found that the practice, indeed, had the program but they didn’t use it. The credentialing specialist would gather provider information, populate it into a file, but felt entry into the software application (App) was an extra step. That was understandable, especially for those of us who had done it the paper-driven way for so long. The staff member actually said, “Hey, I’ve got my file, I’ve got my paperwork, I’m good to go. Why would I need to fill out an electronic form?” This happened because most of the payers still required submission of a printed set of credentialing paperwork, even though the World Wide Web had dozens of examples, per industry, of secure online platforms.

The big game-changer to credentialing came when CAQH (Council for Affordable Quality Healthcare) made the switch to a cloud-based interface. Since then the solutions vendors have offered a number of products to interface with CAQH’s interface to ease the burden of physician data collection and storage.

A host of payers now use the CAQH database to access provider information. While they still require a paper form, they will access CAQH. So, back to the medical practice. While at a conference, we found the solution reps in attendance and they gave us an on-the-spot demonstration of how to use their App. We learned a LOT that day. The biggest plus for us included the fact that once you input physician licensure and personal data-you can go paperless. You can SHRED. IT. ALL. (I know, right?!) This practice now stores large volumes of information, securely, in the cloud. We’ve reduced their space requirements and the risk of security breach. Moreover, this program uploads and downloads provider data for the practice.

Because it’s customizable, when you purchase the licenses, unique forms can be created. Standard forms are also available for your practice. For example, if you consistently use a form for Blue Shield, it is available as an online template.

Once a physician’s data set is uploaded, it allows information sharing. While you remain the App administrator, you can grant viewing rights and share information across the onboarding team. The App also tracks licensure expirations and sends auto-generated reminders, via email. You can set the triggers of how far in advance you want to be notified. Sounds like credentialing Nirvana, doesn’t it?

So, whether for physician credentialing or some other paper-based system, the next time you’re fighting with forms and mailing them into an office, ask yourself: Is there an App for that? With all the time created from eliminating redundant paperwork and reducing administrative anchors, you just might transform your organization, becoming ADEPT℠ at this new business of health care.

Are you ready? We can help.