3 Ways to Improve the Provider Credentialing Process

G2 Group

Written by Dean Lehmkuhler

Welcoming new providers to your ASC should be an exciting process. Whether they’re coming to supplement your current services or to replace a provider who has left, the onboarding process needs to be efficient so caseloads can be properly managed at your center. In order to stay on track, every new provider must be credentialed in a structured, seamless manner. The process needs to be swift, and most important—accurate.

All too often, an ASC’s current system for credentialing has room for improvement. Implementing new routines can be a daunting process, but if you’re focused on improvement, reorganizing will be well worth the effort. By establishing a set plan, you’ll be able to complete your ASC provider credentialing in a way that suits everyone.

Best Practices for Streamlined ASC Provider Credentialing

The credentialing process can often take up to 90 days for an ASC to complete. In order to bring the wait-time down to 60 days or less, your team will likely need to consider some new options. These practices help focus communication between the physician’s office staff and your own reports. That way, your center can complete the process in less time and start scheduling cases—and bring in more revenue—with your new provider.

1. Define the Process

As with any procedural updates, it’s crucial to get changes in writing. The process needs to be clearly defined in order to be followed. Once you outline the steps, anyone on your team will be able to review the process. This, in turn, also makes it easier for everyone to accept and adopt the new system. If the timeline for credentialing has been lax in the past, defining the “ideal” order of events will help keep all parties on schedule.

If you have a working document already, take the time to review and readjust as needed. Making changes to the report will help alleviate any confusion down the road and make it easier to train individuals coming into the role for the first time. When followed correctly, a written process for credentialing should also help to improve accuracy. This creates consistency across the board, both for new providers and long-time physicians at your ASC.

2. Create Accountability

Once the credentialing process is organized, it’s time to find an appropriate person for the job. (For some ASC’s, assigning this responsibility may even come before the process is developed.) Either way, you’ll help eliminate unnecessary steps in the credentialing process when you can hold one single person accountable for collecting and cross-checking the provider applications. The chain of command is easier to follow when there is one primary contact. The physician offices will know exactly who to contact on your site. Plus, there should be less paper-chasing throughout the process.

Since the credentialing role is extremely detail-oriented, it’s imperative that you have the right individual for the job. Mistakes with credentialing can fall back on your site and inadvertently stir up legal issues. A regular review of both your current providers and new applications will ensure your records are always aboveboard.

3. Plan to Verify & Audit

Reviewing each and every primary credible source (PCS) will be the primary role of your designated credentialing team member. Cross-checking is a regular concern in the healthcare world, so it makes sense to have multiple sources of reliable collaboration. It can often help to have an annual audit by a third-party to confirm that your database is accurate.

While the providers are expected to provide accurate information, it’s ultimately the ASC’s job to verify their physicians’ self-reporting and confirm that their licenses are in line with the current requirements. An automated notification system can help alert your team of upcoming review dates so you can start the renewal process on-time. Integrating your administrative duties with the latest technology will help you maintain a responsible credentialing database.

Enhance Your ASC’s Revenue Cycle

By creating a clear process for onboarding new providers, you’re helping guarantee that patients can get the quality care they need at your ASC. As more physicians complete the credentialing process in an efficient manner, they’ll be able to start accepting new cases and revenue streams to your site.

Change isn’t easy, but once these routines are firmly in place, you’ll likely wonder why your ASC didn’t consider making these steps sooner. A single point person for all your credentialing needs can help limit confusion, and an updated IT system will help keep everyone accountable for deadlines and notices about upcoming renewals. When you can approve providers in a streamline manner, your entire system and patients will benefit.

If you would like to continue the conversation, the G2 Group can help. Our consultants specialize in ASC credentialing, healthcare IT, and project management. Please feel free to email one of our experts directly.