DOING BUSINESS
Make Physician Credentialing Easy Steps to make the process more efficient and productive BY MILES BECKETT, MD
What if your physician credentialing process could attract doctors to your prac- tice, take as little as a few hours a month to over-
see and actually increase your billings? I call this intelligent credentialing, and it is achievable. Physician credentialing is a cru- cial component of receiving and main- taining accreditation for your surgery center. Running a safe, efficient and compliant center requires that you pay close attention to your credentialing and privileging process. Achieving this requires preparation, attention to detail and diligent research into accreditation guidelines, all of which can be a chal- lenge while running a busy center. The key to running a successful credentialing program is to follow a set of proven steps: do an audit, set up a system, assign a point person and get buy-in from physicians.
Do an Audit To get started, do an audit of your existing documentation and processes. This involves going through your existing files with a fine-toothed comb and determining where there are issues and what needs to be updated. You will want to compare your documen- tation and processes to those required by your particular accrediting agency, most of which you can find on their web sites.
This can be a daunting process, and without the proper knowledge of regu- latory guidelines, you might miss some details. We have found that 33 percent of the physician files at ASCs that we have audited are out of compliance with their accreditation guidelines. Usually this is the result of missing
documentation of a renewed malprac- tice insurance or professional license, and not the result of negligence or an error in initial credentialing. The chal- lenge is keeping these documents up- to-date in your files, and an efficient process can help mitigate this. There are numerous ASC consultants
who are experts at accreditation compli- ance, and many are willing to audit your existing documentation and systems as part of their consulting services.
Set up a System To paper or not to paper, that is the question. Hospitals switched from paper credentialing files to digital sys- tems long ago, but these products have historically been out of the budget for
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all but the largest ASCs. Now, there are a handful of options for ASCs to go dig- ital. Whether you adopt a fully digital solution or not, you will want a system in place that handles the following:
collects the initial application and cred- ential documents from the physician;
runs primary source verifications of the state medical license, Drug Enforcement Administration (DEA), and additional professional training and qualifications;
runs National Practitioner Data Bank (NPDB), Office of Inspector General (OIG) and other required sanctions checks;
gathers hospital privileges and peer reference letters;
The advice and opinions expressed in this column are those of the author’s and do not represent official Ambulatory Surgery Center Association policy or opinion.
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