Make Life Simpler & Reduce Paperwork – and Input from the 2016 Physician Satisfaction Survey

These days, it’s no secret that paperwork burdens and bureaucracy negatively impact the daily lives of clinicians and administrative staff. Every year, requirements tighten, leaving all affected with little choice other than to move forward and embrace “the new normal”. The paperwork eats away at more and more available time, slowly and surely, and eventually physicians are left to wonder where all their time went.

In taking an impartial look at impacts to practices, the picture becomes clear: everything would be so much easier without the paperwork. The Physician Foundation 2016 Physician Satisfaction Survey solicited unfiltered quotes from physicians on all matters disruptive and frustrating to them, and physicians agreed: paperwork was among their top annoyances. Here’s just some of what they had to say:

“Physicians are… overworked, under-supported and made to jump through unnecessary and burdensome hoops…”

“Let doctors be doctors and eliminate… regulatory intrusions.”

“Excessive and onerous paperwork demands… decrease the availability of physicians.”

“Every month there is ‘just one more little thing’ or ‘it will only take a couple minutes to comply’. These ‘one more little thing’s now take up most of my time.”

It’s clear that physician satisfaction is taking a hit because of regulatory and bureaucratic requirements (read the full survey here). But passing the burden on to other busy clinicians (i.e., a medical assistants or nurses) or highly-paid administrators can have equally damaging consequences. According to the Medical Group Management Association (MGMA), practices could spend up to $7,000 per year tending to a single practitioner’s credentialing files. And there’s more:

  • The average physician spends 43 minutes per day interacting with health plans (MGMA).
  • Practices lose nearly $100,000 in staff wages each year due to the cost of administration related to both credentialing and payer enrollment (MGMA).
  • The average resubmission of a claim takes a biller 16 minutes (GPRN).
  • The average physician is submitted for credentialing to 13 or more health networks (GPRN).
  • Physicians and support staff spend an average of 82 minutes completing each health network application (GPRN).
  • Negotiation of a single payer contract can eat up more than 350 minutes of physician and administrator time (GPRN).

The numbers don’t lie: paperwork isn’t just annoying… it’s expensive.

Leaving out the cost of credentialing and provider enrollment, facilities in the United States lose somewhere around $125 Billion annually because of disorganized or poor billing practices (Huffington Post). Untrained staff can cause numerous issues for a practice if not imbued with knowledge necessary to avoid legal and regulatory pitfalls.

Sure, not all paperwork can be eliminated. But what if solutions existed to give physicians time back into their schedules, allowing them the opportunity to focus more on patients and their charts?

At Paramount Professional Services, we’re prepared to offer just that: an opportunity for physicians to adjust their working lives in order to focus more completely on patient needs. We’re experts in billing, coding, credentialing and enrollment, and we’re equipped to support practices to the fullest. By outsourcing paperwork processes, practices stand to:

  • increase physician work satisfaction.
  • free up more time for practice administrators, nurses and medical assistants to focus on their jobs, too.
  • increase focus on regulatory and legal requirements surrounding billing, coding, credentialing and enrollment.
  • work more efficiently! We strive to bill claims correctly the first time. If not, we take care of the follow-up and contact physicians and office staff only if necessary.
  • get your new physicians up and running quickly and efficiently. We know the ropes at area hospitals and with insurance payers, and we work to help ensure a seamless physician onboarding experience.
  • Best of all, we keep the paperwork to an absolute minimum, and supply the data most desired by physicians and administrators.

No matter the specialty, a new practice or well-established, Paramount Professional Services is prepared to offer tailored solutions to improve operations and revenue. Give us a call, send an email or drop by today!



7 Reasons to Consider Shared Credentialing Resources

In attending various talks and participating in meetings with departmental leaders, it became clear to me that not every professional is aware of credentialing needs beyond their own purposes. There’s nothing abnormal about that, as facilities which separate out credentialing-related tasks often end up unknowingly growing significant information silos, and those departments don’t collaborate nearly as well as they should.

 Provider credentialing is all about perspective, and a number of differing perspectives are easily confused, and lumped in as simple “credentialing”. Rather, there are three primary perspectives to consider: those of the credentialing facility, the enrollment specialist, and the insurance company or payer. All three have differing agendas, and all three can have widely varying processes and needs.

The need for these departments to work with some cohesion has become better recognized in recent years. Numerous hospital systems and facilities are looking to combine provider enrollment and provider credentialing departments into a single unit. While this approach is not strictly necessary and, in some cases, detrimental, bridging understanding gaps between these functions is essential.

The credentialing facility is looking in from a patient and organizational safety perspective. Is this provider appropriate to be onboarded to the desired Medical Staff? Credentialing specialists will work behind the scenes to validate that this physician’s past and declared experience are both appropriate and accurate. Along the way, they’ll be looking for signs and red flags, and intuiting as much as they can about the provider. Additionally, credentialing specialists will be looking to participate well within the regulations of their accrediting body, if applicable.

The Enrollment Specialist will be concerned with getting this physician ready to submit claims to payers (federal, state and private). The specialist may perform some credentialing tasks, such as pulling licensure and other documentation to accompany the application. The enrollment specialist will also need to work as closely as possible with the provider to ensure that all applicable information is correct, and that no omissions have been made – regulatory and legal standards are stringent for physicians who omit important disclosures, even if those omissions were made in genuine error.

The payer or insurance company may investigate providers just as fully as a credentialing facility. Depending on the provider type and the policies of the insurance company, the file can be quite extensive. The payer or insurance company will contact the enrollment specialist for any missing documentation or assistance in procuring documentation. This can be a team effort.

For the most part, the work of the payer credentialing system will be silent; therefore, I’ll just focus on the duties of Provider Enrollment Specialists and facility Credentialing Specials.

Here are seven specific reasons to consider putting heads together:

Decrease or Elimination of Redundancies

 Here’s the thing: physicians are busy, and have limited time to give to the credentialing and onboarding processes. Oftentimes, enrollment specialists and credentialing specialists consider the time necessary to bring a new physician on staff. For provider enrollment, 60 to 180 days is standard. Depending on the policies of the Medical Staff, it can be the same or longer for a physician to gain privileges.

While the facility is busy preparing for the new physician, the physician is still carrying on their busy practice in the meantime, or in the process of an arduous cross-country move. Extensive paperwork coming at the provider from two different departments ensures that items will likely fall through the cracks, or that the physician may even feel alienated or like his/her time is not seen as important. Schedule time for departments to meet with each other, and determine which paperwork can be eliminated or combined. Physicians will thank you for it.

Engender Mutual Understanding

As mentioned, sometimes the goals of each department can be diametrically opposed. Effort should be made to explain to the other department the processes in play and why they exist. The need to maintain profitability and the need to maintain patient safety are both paramount to the success of a healthcare organization. Employees of each department should understand why the other perspective is both necessary and potentially helpful to their own goals.

Increased Communication = Faster Onboarding

 I would be willing to bet anyone who’s been in this industry for any length of time has seen it happen: A new physician is coming; his contract is signed, he’s met his new business partners, he’s had lunch with administration. He’s filled out his Pre-Application with the Medical Staff Office, and he’s working on his full application, and he’s already put in an offer on a house. Things are going great, and it seems like everyone is ahead of the game, weeks and weeks into the process. And then… wait! No one told the Enrollment Specialist. But this physician is scheduled to start working in six weeks, and it takes up to four months to enroll a physician. This will mean a large payment gap for the practice, and more than likely, a great deal of blame will be thrown about.

Departments comfortable with working together better avoid these situations. Their processes are intertwined and, therefore, everyone knows precisely what they mean to the other department. There is a clear process for which employee needs to notify the other department of an incoming physician. It may seem like an obvious step, but it’s missed often enough. It’s important for these departments to keep in touch!

Reduction in Error

 The less typing, the less unintentional error. In an ideal world, provider enrollment specialists and credentialing specialists would share the same software platform. This would help streamline the separate processes, help individuals extract the information they need, and help to avoid those pesky information silos. It’s not always possible, but at the very least reduction in error should be an incentive to tighten processes and share information whenever possible.

Better Provider Relations

 This goes back to reducing redundancies. Physicians have an appreciation for individuals who make their lives simpler – not more complicated! Payment and onboarding are both very important to physicians, and are often some of the first experiences they have with the new facility. Take advantage, and craft processes which simplify the onboarding process, and demonstrate the savvy of the facility. For example, strive to add no duplication to the state provider credentialing application or new physician application used. The Medical Staff Office can collect the application and send it to the provider enrollment specialist, or vice versa. If licensure and other documentation are available in a central location, it’s unnecessary for the each department to pull documents or inquiry physicians separately.

More Accurate Record-Keeping

If one department is responsible for updating provider demographics, and systems are accessible by both departments, error is easily avoided. An alert system for updated demographics could be helpful to inform the other department when it’s necessary to log in and review updated information, in the event that updates are needed in payer portals or other payer applications.

Safer Privileging Practices

The process of privileging is enormously important, and separate of credentialing. Each facility must perform its due diligence and analyze a practitioner’s ability to carry out each privilege reasonably granted to them, and to identify deficiencies. Depending on the presence of an accrediting body, those standards can be highly delineated and complicated. When there is interdepartmental understanding and action is taken to ensure proper time to vet applicants, those individuals responsible for granting privileges are better able to take time to properly evaluate applicants. Clear communication can help to avoid the “time crunch” and produce a better, safer onboarding experience.

Provider enrollment specialists and credentialing specialists may have differing perspectives, but their ultimate goal should be the same: the onboarding of a qualified physician. Each department has the capability of helping or hindering the other. Processes must be designed to facilitate the sharing of information and responsibilities. Otherwise, experiences within the department and, more importantly, the experience of the physician, may paint an unpleasant picture of individuals and the facility. As in most situations communication is key: How can departments or individuals better facilitate each other and create a dynamite onboarding process?