Credentialing & Privileging

How to make your initial application user-friendly

Credentialing Resource Center Connection, August 9, 2007

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Sally J. Pelletier, CPMSM, CPCS, is a consultant with The Greeley Company, a division of HCPro, Inc., specializing in the areas of credentialing and privileging.

Dear credentialing colleague:

The dog days of summer have arrived. However, July and August are rarely slow periods for a medical staff office (MSO). The processing of new applications for medical staff membership and clinical privileges must continue even though these summer months are packed with vacations, causing a reduction in personnel in the MSO. This makes it difficult to reach applicants for answers concerning their application packets and problematic to schedule time for your medical staff leadership to follow through on credentialing and privileging related tasks.

All the more reason, then, for your organization's initial application to be user-friendly. When was the last time your MSO evaluated the content of your application with an eye toward making it more accessible, adding necessary fields, eliminating those areas that provide you with information of little or no value, and ensuring that it does not ask for unnecessary documentation (e.g. copies of diplomas, certifications, licenses)?

If your organization is still utilizing a system that requires you to mail a hard copy of the application packet to the applicant, and then requires that he or she complete the form in writing before mailing it back, it is way past the time to explore the electronic options via the Internet. This eliminates the need for medical staff office personnel to manually provide the packet to the practitioner, which can be a huge drain on both environmental and staff resources.

Many states also have created an electronic application. If your state has done so, and mandates that your organization utilize that particular form, you may not be able to control the content. However, what you can control is the operational aspect of how your MSO receives the information and logs it into your credentialing database. (Please note: In many states the National Association Medical Staff Services state affiliate would have provided input into the content of that application. If you are a medical service professional and have concerns about the content of your state application, it is good practice to contact your NAMSS state affiliation and share your ideas as to how the application could be improved.)

There are several clues that you should look for when determining whether your application is sufficient.

First, do you find yourself constantly having to go back to the physician for additional information? If so, is this because the form itself lacks the necessary questions to give a clear picture of the applicant's past?  For example, do you ask for a written explanation of gaps up-front versus going back to the practitioner after you determine that there is a gap and your application did not direct them to provide the information?  Or, can you not even tell if there is a gap because your application does not ask for specific dates (i.e. from dd/mm/yy to dd/mm/yy) for education, training, and work experience?

Secondly, are applicants attaching documentation that is really unnecessary and offers no value to the credentialing process simply because the application directs them to?  

When reviewing your application think of it as a communication tool. Does it contain the necessary elements that your organization needs to perform its due diligence on the applicant? Does it require them to jump through unnecessary hoops that provide no value related to patient care and safety, contrary to a best-practice credentialing process?  Does the application ask the necessary questions to satisfy a Joint Commission-required evaluation by the organized medical staff regarding the voluntary and involuntary relinquishment of any license or registration; termination of medical staff membership; limitation, reduction, or loss of clinical privileges; health status; and professional liability actions?  

Lastly, think about your initial application from a customer-service perspective. Who are the other "customers" that will ultimately be using the information that you draw from the application to populate your credentialing database? Typically, such "customers" include physician recruitment, public relations/marketing, hospital-owned medical groups, practitioner enrollment, physician referral services. Your office should work together with these entities to determine whether these other stakeholders need certain elements added to the application, and if making such changes would eliminate the need for the applicant to complete an entirely different form.

As always, remember to check your hospital policies and with legal counsel on the sharing of information.

Remember, credentialing has no other master than the patient.

That's all for this week.

All the best,

Sally J. Pelletier, CPMSM, CPCS
http://www.greeley.com/consulting.cfm



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