Delegated Credentialing in the Medical Staff Services Department

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There are several reasons why a commercial payer, such as a managed care organization or health plan, may consider delegating all or part of its credentialing activities to qualified business partners such as IPAs, PHOs, CVOs, medical societies, even other health plans. However, a growing trend observed by The Greeley Company is for hospitals and… [Read More]

The New Paradigm: Delegated Credentialing in the MSSD

NOTE: This post originally appeared on the Greeley Membership blog.

The Situation: The number of employed practitioners at your hospital is increasing. Provider enrollment with the managed care payers is time-consuming and long delays are being encountered. A significant loss of revenue has been incurred over the last year due to the inability to bill for patient care services while your practitioners waited to be… [Read More]

NPDB Guidebook and Reporting Requirements – One year later

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In April 2015, the National Practitioner Data Bank (NPDB) published its first new guidebook in 13 years. It includes a significant expansion of the NPDB’s definition of an investigation with direct impact on reporting requirements for physicians or dentists who resign while under investigation. The impetus behind the expanded language is seemingly based on troubling… [Read More]

Practitioner Credentialing in an Era of Heightened Employment, Consolidation: 4 Strategies to Tame the Beast

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As more practitioners and newly-minted medical school graduates seek hospital-based employment, the need for quality credentialing grows. On top of this, as hospitals form more expansive networks and systems, small inefficiencies in individual credentialing processes compound and become increasingly disruptive at the network and system level. Even the best hospital credentialing and privileging processes, when… [Read More]

Stop the Line: Credentialing for the OR

NOTE: This post originally appeared on the Greeley Membership blog.

“Stop the line” is a very familiar term to me, through my years of experience in the hospital setting. It is a term that is more commonly used in the OR suite, but not uncommon in all patient care areas of the hospital. Having the authority—or more importantly, the responsibility—to take a stand and “stop… [Read More]

Free Download: Credentialing Compilation Guidebook

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My colleagues from The Greeley Company and I hope that you’re enjoying this holiday season and feeling energized for the New Year! I’m reaching out to offer you a free PDF copy of a resource our team recently created, The Greeley Company’s Credentialing & Privileging Compilation: A Selection of Articles, Case Studies, and White Papers. This 66-page compilation includes 17… [Read More]

NAMSS Annual Conference 2015 Musings

A little over a week ago, I had the “NAMSS experience.” This year’s conference theme was about embracing change. Very apropos given the transformations the medical services profession is facing as a result of the ever-evolving and yet unprecedented changes in the delivery of healthcare. My use of the word “experience” in the above paragraph… [Read More]

To Report or Not to Report: What to Do about the Recent NPDB Guidebook Update

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In April 2015, the National Practitioner Data Bank (NPDB) published its first new guidebook in 13 years. It includes a significant expansion of the NPDB’s definition of an investigation with direct impact on reporting requirements for physicians or dentists who resign while under investigation. The impetus behind the expanded language is seemingly based on troubling… [Read More]

Multifaceted Engagement Leads to Credentialing, Privileging, and Bylaws Improvements

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The Chief Executive Officer/General Counsel and Credentials Chair of a 25-bed, physician-owned surgical hospital in the Midwest both attended one of The Greeley Company’s national seminars, The Credentialing Solution, in San Diego in early 2015. They were impressed with the content of the seminar and followed up with The Greeley Company about conducting a gap… [Read More]