COMMON GOALS Now that HHSC has initiated im- provements on the enrollment side, “we are looking into creating an inter- face between the statewide credential- ing organization and the enrollment file,” he added. “It will certainly make this project work better, so we want to be in lockstep with HHSC on this.” Next steps also would include a series of workgroups among health plans to standardize certain creden- tialing elements. Dr. Peterson clarifies, however,
that having a single repository does not translate to automatic approval by health plans, which must still screen physicians’ qualifications through their credentialing committees. “It doesn’t negate that. But it would hope- fully give everyone one place to go, in- stead of having paperwork all over the place.”
Driscoll is one of several health plans doing that to some degree now, by choosing to pay a common vendor to gather physician credentials. Phy- sicians can submit the information free of charge. The problem, says Dr. Peterson, is the information is not al- ways up to date. In the meantime, Mr. Jessee says HHSC also communicates to Med- icaid HMOs that nothing prevents them from starting the credentialing process while they wait on enrollment confirmation from Texas Medicaid. Some plans already do so, but TMA
is urging HHSC to adopt the approach as a best practice for all Medicaid HMOs to expedite physician creden- tialing, in addition to the protections created under SB 760. “There are a lot of good things go-
ing on,” Mr. Jessee said. “This is a big deal.”
Amy Lynn Sorrel is associate editor of Texas Medi- cine. You can reach her by phone at (800) 880- 1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email at
amy.sorrel@
texmed.org.
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August 2015 TEXAS MEDICINE 59
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