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 is intentional. Yes, I am referring to the NAMSS experience as an event. But I am also referring to its other meanings:
- As a noun: Knowledge, involvement, know-how, proficiency
- As a verb: To face, undergo, feel, go through
Regardless of the number of years one has been a medical services professional (MSP), there are many new situations we are encountering that test our proficiency and can generate feelings of uncertainty.” For example, we are fielding questions related to where the field is headed, our increasing knowledge base, and our know-how regarding the appropriate staging and alignment with what previously seemed to be unrelated functions (e.g., recruitment, credentialing, enrollment, onboarding, and revenue cycle).
Many MSPs discussed their specific challenges with me at NAMSS, describing how they are being asked to do things or be responsible for areas with which they are unfamiliar. I encouraged these individuals to step up to the challenge and ask questions, read, network, and revisit each and every process they currently perform to make sure they are seen as a good steward of valuable healthcare resources.
What are your top ten NAMSS takeaways? Here are mine:
- Continuously improve processes to avoid successful negligent credentialing claims. Credentialing operations should be designed to ensure that patients receive safe, competent, and compassionate care from all credentialed and privileged practitioners.
- Question the status quo—which likely means discarding old, outdated practices and starting from scratch. Credentialing operations should recognize practitioners as customers of the credentialing function, and be designed to be efficient and “user-friendly” while also meeting regulatory requirements and incorporating best practices.
- View your processes through the eyes of the practitioner to design processes that are seamless to practitioners, paperless to save time and facilitate sharing of information, and efficient to eliminate duplication and non-value-added work.
- Allow local autonomy and control to remain where it makes sense to do so, while also reaping the benefits of “systemness” where appropriate. Decentralization is passé. Centralization is the way of the future. With standardization and structure typically comes consistency, a reduction in errors, and reduced risk.
- Explore delegated agreements with third-party payers—it will eliminate most of your enrollment issues. Conduct a gap analysis to determine your compliance with NCQA standards.
- Embrace technology and cultivate IT support in a meaningful manner.
- Assertively shepherd credentials files through the steps of credentialing. Inaction or passive management of credentials files leads to unacceptable turnaround times and dissatisfied practitioners and administration.
- Revisit your approach to telemedicine. Can you alleviate some of the burden through the creation of an appropriate structure that includes building trust with your telemedicine service provider and credentialing by proxy?
- Question whether your organization’s approach to authorizing practitioners to practice in provider-based clinics is appropriate and compliant. If it is not, take action to ensure that practitioners are authorized through a medical staff privileging process with appropriate peer review.
- Recognize that advanced practice professionals will continue to play a crucial role in the delivery of healthcare. Are you sure your privileging forms and performance monitoring processes have kept up with the evolution of these practitioners and their expanding scope?
The Greeley Company can assist healthcare organizations with achieving success in any of these 10 key take-away areas and with any other credentialing, privileging, and practitioner performance challenges. Should you wish to discuss the above or any questions or needs you might have, please contact us at (888) 749-3054 or email firstname.lastname@example.org. We would be happy to share stories of organizations that The Greeley Company has served and would welcome the opportunity to explore whether we can be of service to you.
The world as we have created it is a process of our thinking. It cannot be changed without changing our thinking.― Albert Einstein