The Top Oversights in Physician Credentialing & How to Fix Them

Physician credentialing is one of the most important (and most painstaking) tasks that administrators in ambulatory surgery centers manage.

Patients place their trust in their doctors – and it’s a center’s responsibility to verify that all practicing physicians have up-to-date credentials and documentation. ASCs must develop a thorough credentialing process in order to maintain efficient operations and comply with regulatory standards, including requirements for the Joint Commission and Medicare.

Credentialing guidelines are complex, with industry, municipal, state, and federal variations. Here are a few of the primary challenges administrators encounter throughout this process, as well as best practices for addressing them.

  1. Credentialing a new provider takes time.

It can take 60 to 90 days to fully credential a new provider, which has to be completed before they can take on any patient cases. ASCs must meet the requirements for their state; and while most states have similar prerequisites, the specifics do vary.

Administrators should start early, and go through a physician’s file with a fine-tooth comb, verifying education, training, licensure, and employment history. If they discover any red flags or have unanswered questions, it’s wise to do additional research. Taking a closer look now can bring potential problems to light, and protect the ASC from risk.

  1. Peer references are hard to track down.

Since physicians have busy schedules and manage many responsibilities, it is often a struggle to secure peer references for credentialing. The best approach is to have the physicians reach out to their peers first, notifying them that a request is coming, and proposing a timeframe for its completion. Then administrators can follow up, checking in on the reference’s progress, offering support, and reviewing it for accuracy.

  1. Documenting a long career is difficult.

For physicians who have many years of experience, the credentialing process is even more exacting. They are obligated to document their extensive work history, providing details about every hospital and center where they practiced.

The good news is that electronic medical records have made it easier to find this information. It will be more demanding for administrators to locate data from decades ago, but once they do, it can be saved for later use in secure cloud storage.

  1. Keeping physicians up-to-date is daunting.

For ASCs to stay current for Joint Commission surveys, practicing physicians are required to have their credentials reevaluated every one to three years. But because physicians all have different timelines for reevaluation, this is a complicated juggling act for ASC administrators. To streamline this process, they should use a comprehensive software solution that enables them to organize records, monitor deadlines, share files, and search for documents. One staff member can be the point person for credentialing tasks, checking in every week to make sure the ASC is keeping up with all necessary requirements.

ASCs interested in learning more about MedHQ’s credentialing process can learn more here.

 

Alleviating Hostile Work Environments & Harassment Claims

Ambulatory surgery centers rely on a highly skilled, experienced, and engaged workforce to run efficiently in a change-driven industry. These healthcare professionals have demanding and fast-paced jobs, and they need to work in a safe and supportive environment in order to provide the best patient care.

ASC leaders are responsible for creating a culture where all employees are treated with kindness and respect, regardless of gender or other characteristics. The following best practices aim to mitigate risks associated with sexual harassment, general harassment, and a hostile work environment.

Adopt a “top-down” approach.

ASC leaders must model the standards and behaviors they want to see in their organization. It is their duty to define and enforce clear harassment policies, both in formal guidelines and casual everyday conversations. An employee handbook should outline in writing the processes and procedures to be followed if a harassment claim is filed. And leaders should talk often about the behaviors they expect, and those they won’t tolerate.

Be proactive about addressing risks.

Negative interpersonal behaviors can sour a work environment quickly. Leaders must be proactive about preventing them, incorporating steps such as:

  • Online and in-person training about unacceptable behaviors
  • Frequent conversations about shared beliefs and values
  • Positive recognition of those demonstrating company values
  • Programs to strengthen culture
  • Leaders demonstrating desired behaviors
  • Zero tolerance policies for harassment

Address problems early on.

To foster a positive work environment, employees must feel supported in speaking up about any complaints they have. Whether they are bothered by an uncomfortable incident or an ongoing pattern of harassment, they need to have a safe space to air their concerns. This may involve a short, in-the-moment conversation when someone says something improper. Or it might require more official protocols. Especially with delicate situations, managers shouldn’t hesitate to involve human resources experts who can guide productive discussions, facilitate conflict resolution, and follow up with additional actions.

Learn how MedHQ utilizes its expertise to help ASCs mitigate HR risks.

New White Paper by MedHQ Delivers Proactive Strategies to Mitigate High-Risk HR Events for Surgical Facilities

When it comes to high-risk human resources events, ASCs need to ensure they understand how improperly handling adverse events in human resources (HR) can significantly derail workforce productivity, cost tens of thousands of dollars and cause upward pressure on insurance rates. To assist with that effort, a new guide from MedHQ titled, How to Mitigate Your ASC’s Top 5 HR Risks, provides ASC leaders practical and proven strategies to implement at their facilities.

Launched in 2003, MedHQ assists ASCs with improving revenue, enhancing company culture, and taking time-consuming tasks off the plates of administrators, allowing them to focus on the high-value priorities of running and managing surgery centers. Since 2011, MedHQ has tracked a “Top 10” of HR risk management issues, assigning a monetary risk factor to each event. Today, the company has hundreds of such events in a database, and helps clients gain the benefit of that history.

“In an environment of rapid change, ASC leaders are already stretched thin,” says Tom Jacobs, Co-Founder and Chief Executive Officer of MedHQ, the leading provider of human resources staffing and onsite management services focused specifically on the ASC market. “This topic matters for ASCs and out-patient healthcare businesses because HR risks divert the attention of senior management, distracting them from their goals to improve the quality of care, and improve business results.”

MedHQ’s Vice President of Human Resources, Rita Hernandez-Figi works with ASCs nationwide to provide the business insight they need, so organizations can keep their focus on their patients. “When it comes to preventive practices, it’s all about being proactive vs reactive. An experienced HR team knows how to craft a job description, recruit the right candidates, and implement an interview process that brings candidates with the best skills and fit to the top.”

Hernandez-Figi uses her deep expertise as she addresses the top five high-risk HR events including: FMLA/ADA interactions, workers’ compensation claims, involuntary termination, sexual harassment and hostile work environments.

For ASCs, the key to success with high-risk events is to leverage an expert HR skill set to mitigate risks by aligning HR best practices to business strategy and integrating competent HR execution into every day operations.

ASC leadership interested in more tips and recommendations for leveraging accurate, insightful leadership counsel can download the full white paper here.

How to Mitigate FMLA/ADA Interactions

For many busy healthcare executives, employment practices matters are often secondary to more immediate problems. But while employee/employer challenges might not seem pressing in the moment, if they aren’t addressed, they can become critical and costly in the future. Executives must anticipate and mitigate these risks before they damage an ASC’s reputation, finances, or work environment.

One of the top employment risk management issues is the intersection of the Family and Medical Leave Act (FMLA) and the Americans with Disabilities Act (ADA), which oftentimes comes on the heels of a workplace injury and workers’ compensation insurance claim. The following action steps are designed to help ASCs make plans to protect their employees and their organization.

Understand the rules.

FMLA and ADA, along with worker compensation laws, exist to establish protocols for employees and organizations to follow in specific scenarios. The regulations are intended to safeguard all parties involved. Healthcare executives should have a comprehensive understanding of the laws and their parameters. Under which circumstances does FMLA or ADA – or both – apply?

Outline clear job descriptions.

Every position within an ASC must have a detailed job description that outlines its essential tasks and responsibilities. This is a vital element of managing the interaction between FMLA and ADA; it prevents misunderstanding and clarifies expectations.

Negotiate accommodations.

With a concrete description in place, it is easier to separate mandatory job functions from tasks that may allow for flexibility. This clarity facilitates an FMLA/ADA discussion and minimizes cause for dispute. For example, an office manager with a back injury may be able to negotiate reasonable accommodations for the job, such as delegating filing and moving boxes to another employee. But for a nursing position, accommodation may not be possible if this condition makes essential functions of the job – like lifting a patient – impossible.

Determine next steps.

Conversations about FMLA/ADA issues should happen early and often. It’s especially important for ASC executives to manage situations carefully when an employee is nearing the end of the 12-week, FMLA-allowed leave. This intersection point between FMLA and ADA is where ASCs often make mistakes, putting them at risk for claims. Every situation is different, so assumptions are dangerous.

Executives must work with employees to determine medical limitations, essential job functions, and options for returning to work. Sometimes it’s possible to temporarily restructure a position, or offer a short-term, modified description of job duties. In other scenarios, there isn’t as much room for adaptability. HR professionals are valuable resources in this phase, bringing their expertise to the process.

Learn how MedHQ helps ASCs mitigate HR risks.

2017 Sets Tone for Continued MedHQ Growth | MedHQ

2017 Sets Tone for Continued MedHQ Growth as Strategic Resource

Rolling into the new year ahead energized by the successes of 2017, MedHQ Chief Executive Officer and Co-Founder Tom Jacobs shared his outlook on the challenges and opportunities for ASCs in 2018 and looked back on a few of MedHQ’s key accomplishments over the past year.

“As we continue to build on our relationships with ASC management companies, and as independent ASC physician-hospital partnerships increasingly look to us to add efficiency to their operations, our outlook for 2018 is really good,” Jacobs said. “ASC and hospital CEOs agree that as a strategic outside resource, we can be a much more focused and efficient way to deliver HR services. And they need to bring every efficiency they can to succeed in today’s dynamic healthcare market place.”

MedHQ’s 2017 growth underscores this observation. While the company enjoyed significant growth across all three of its service lines – Human Resources Services, Accounting Services, and Physician Credentialing – MedHQ grew 50% over the past two years in the realm of HR Services. Jacobs attributes a significant portion this growth to MedHQ’s deepening partnerships with ASC management companies as clients.

“There is a growing recognition that just as in healthcare there are specialties and subspecialties, so too in management,” he said. “There are some great management companies in the ASC space, but HR is so broad and deep they recognize a real need for a subspecialist. They’re looking to us as a partner, not a competitor.”

Supporting its rapid growth in HR Services, MedHQ invested in a strategic new hire late in 2017, adding HR executive Rita Hernandez-Figi as Vice President, Human Resource Services. Hernandez-Figi spent 16 years directing HR at Insurance Auto Auction – which operated in 49 of the 50 states, plus Canada – and was previously an HR leader with ServiceMaster, Inc.

The firm also upgraded to a new HR technology platform – PrismHR – to help clients to automate electronic onboarding, benefits enrollment, integration with back office systems, and eventually to tie HR data to the key business intelligence statistics that guide Board decision-making.

“Our growth – and the highly adaptive solutions we offer – closely fit healthcare trends as more care moves to an outpatient setting,” Jacobs observed.  “Smart hospital operators are understanding that ASCs are partners and not threats, and a similar realization is happening in HR. As the hospital C-suite becomes part owner in the ASC, they care more about expertly managing HR risks.”

Jacobs explained that outpatient care requires a more dynamic, highly efficient, fast-paced environment, so the need for an adaptive back office comes part-and-parcel with the transition from in-patient care.

“As a subspecialist, we can use our platform to implement HR solutions relatively easily on a facility-by-facility basis. MedHQ’s new HR software platform is a web-based, cloud-based service, so it’s simple to replicate, and offers universal access and instant data sharing even if your management team, accounting and HR services, and hospital partners are all in separate locations.”

MedHQ’s Accounting Services offering also enjoyed growth in 2017, and Jacobs expects that success to continue in the new year as well. Leveraging a team of experienced healthcare accountants, MedHQ provides ASC clients with an accurate, up-to-date picture of the current financial state of their businesses, tailoring services to each client’s specific needs, and acting as trusted advisors.

“We understand the healthcare revenue cycle and apply that knowledge to offer financials that become critical decision-making tools for ASC managers and administrators,” Jacobs said. “The bottom line is, our clients have confidence in us because we help them maximize business performance.”

To learn more about MedHQ’s services, click here.