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.


MedHQ Named on “150 Top Places to Work in Healthcare” List

MedHQ earned a place on the Becker’s Healthcare “150 Top Places to Work in Healthcare” list for 2018.

The highly regarded list identifies healthcare organizations doing outstanding work to further professional development, leadership, diversity, and engagement among their staff. Becker’s selects hospitals, health systems, and healthcare companies that offer employees exceptional opportunities to grow and thrive. It is the second consecutive year that MedHQ has been featured on the list.

“We are thrilled to be named one of the best places to work in healthcare,” said MedHQ CEO and Co-Founder Tom Jacobs. “Our mission is to help our clients create a culture where employees love their work, and receive the support and mentorship to deliver excellent patient care. It’s an honor to be recognized by Becker’s for instilling this same supportive culture in our own company.”

In 2017, MedHQ experienced significant growth across all services – Human Resources Services, Accounting Services, and Physician Credentialing. But the greatest growth was within HR Services, where the company saw a 50% increase over the past two years, as it built lasting partnerships with ASC management companies.

To support this development and continue its focus on company culture, MedHQ added a new executive team member in December 2017: Rita Hernandez-Figi as Vice President, Human Resources Services. Hernandez-Fiji brings a wealth of human resources experience to the company. Before joining MedHQ, she spent 16 years as Vice President of Human Resources at Insurance Auto Auction, directing HR operations across 14 international and 170 domestic locations.

“A strong company culture starts at the top,” said Hernandez-Fiji. “The leaders must have a clear vision of what kind of organization they want to be. They have to model and communicate these core values, and foster an environment where employees can do their best work.”

Learn more about MedHQ’s HR Services.

Why ASCs Should Partner with HR / Staff Management Firms

MedHQ was recently consulted by a colleague about a growing healthcare management company. With over 100+ employees in ten facilities across the Midwest, the management company expects to double by the end of the year and is looking for systems to help manage the growing employee base.

To assist with the growth, the management company is looking for an applicant tracking system (ATS) to assist in tracking candidates throughout the application and interviewing process, as well as a human resources information system (HRIS) to manage offer letters, tax forms, compliance issues and more. In addition to that, the management company will likely transition to larger payroll company by the end of the year.

The question the healthcare management company posed was, “Should we build it, or should we buy it?”

Many companies opt to build the systems themselves because they are unsure if traditional PEOs, long-term staffing companies and HR Outsourcing (HRO) firms in general can resolve all their concerns while also maintaining a high standard of employee satisfaction. However, once a company reaches significant growth, outsourcing day-to-day human resources operations can free up valuable time and resources. Or, on the other hand, perhaps the company has a wonderful HR team internally that helped them get to where they are currently. For either scenario, we could make the case for HRO (“Buy”) instead of investing further in the internal HR function (Build).

If the growth has outpaced the internal operations, an HRO firm delivers an out-of-the-box solution that handles the areas mentioned with technology operated by HR and payroll professionals that have full proficiency in their roles. There are many good ATS and HRIS platforms; at least as important is how they are set up and how well the staff is trained and practiced in using the systems.

For development of an internal HR function, the question is whether it’s best to focus some or any of the executive management attention and capital investment in a support function. What creates value for a company? Likely that it includes developing relationships and delivering top clinical care to more and more patients – these and similar areas is likely what gets executive management’s focus and most capital investment.

At MedHQ we specialize in the healthcare industry, and because of this, can better understand our clients unique HR needs. Currently, we use PrismHR, which happens to be built specifically for the HR outsourcing industry. This system is automating our employee onboarding (paperless), benefits enrollment (paperless) and, of course, handles payroll. We have integrated PrismHR with our time and attendance system and we have an applicant tracking system as well. PrismHR just recently added a CRM capability to its core platform and we’re going through the implementation of that component now – this capability is going to greatly enhance our service to employees through more effective case and task management.

As an HR Services company, we will continue to invest in the best solutions that hit the HR market because these investments will drive value in our company. We find, however, that companies that opt to build internal solutions are susceptible to having those systems atrophy due to lack of ongoing investment.

What an HRO firm is and what it isn’t: HRO’s handle back office matters that are extensive – we break it down to a dozen or so areas and 100 or so separate activities – but almost entirely in a “support” mode. Management (the customer’s management team), on the other hand, is the “front office”. The HRO handles the essential or basic HR functions, while Management supervises and develops the organization. An HR Generalist fits well within the typical service model of a HRO, while an organizational development consultant is best fit within Management Consulting. A HRO’s leverage is its size and risk sharing model. The size creates efficiencies for the customer; the risk sharing removes barriers that get in the way of a customer’s growth.

Lastly, when it comes to culture, we would consider the development of a company’s culture to be the responsibility of the Management team. While we love to work on culture-supportive programs, we believe that for an organization to intentionally create a culture requires top leadership to spearhead the effort.

Interested in learning more about MedHQ’s unique HR services, click here.

Learn more about mitigating employment risk by downloadingHow to Mitigate Your ASC’s Top 5 Employment Risks. 

Steps to Take to Manage Involuntary Terminations

Every ambulatory surgery center needs a professional, dedicated staff to provide excellent patient care and operate efficiently. Successful ASC leaders are thorough in recruiting and hiring employees who are the best fit for their team, and modeling the culture they want to see in the organization.

But despite these efforts, there will still be times when an employee is not working out, and an involuntary termination is the best course of action. This is a delicate situation that can cause financial strain and employee stress for an ASC. Research suggests that a single termination, poorly handled, can cost $80,000 to $125,000 in legal fees and severance, compared to expenses of $5,000 to $10,000 when managed properly.

The following human resources best practices will mitigate risks associated with involuntary terminations.

Have direct conversations about performance and behavior.

When an employee is not meeting expectations or is behaving in an inappropriate way, management must step in and address the problem early on. A direct, private conversation with the employee should focus on specific examples of what is happening, and what needs to change going forward. Is there a reason for the employee’s behavior? Has something, such as a new work process or a problem at home, triggered this change? Leaders in the organization are responsible for starting this conversation, exploring possible solutions, and setting next steps.

Follow a progressive discipline process.

Progressive discipline is designed to bring unacceptable behavior or poor performance to an employee’s attention and outline the changes necessary to avoid involuntary termination. For example, if a manager notices an ASC employee who has a problem with arriving for work on time or missing shifts, this process might look like this:

  • First incident: Manager clarifies job expectations and responsibilities, and issues a verbal warning about the consequences of missing work
  • Second incident: Manager pulls the employee aside when the employee has arrived at work 40 minutes late, emphasizing that this is the behavior that must change, and documents the issue in writing, using a formal written reprimand
  • Third incident: Manager involves human resources and a determination is made as to whether an Employee Consultation or a final formal written reprimand is the next step. (In some situations, a suspension or demotion may be warranted)
  • If an Employee Consultation is scheduled, the employee and manager will have the opportunity to review the fact. After consideration of facts, a decision is made regarding involuntary termination.

Diffuse the impact on remaining employees.

When an involuntary termination is necessary, it’s important for leaders to take proactive and professional actions to make the transition as seamless as possible. The conversation that ends the staff member’s employment should be brief and respectful; it will not be a surprise, as it is a culmination of many previous steps and conversations. Immediately after a termination, management must inform the remaining staff of the change and prevent rumors from spreading. Leaders need to be prepared with a plan – answering questions, sharing what they need from employees in the short term, and showing that they are working to fill the vacancy as quickly as possible.

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

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.

Due Diligence Uncovers Savings

Leaders of ASCs are responsible not only for safeguarding the health of their patients, but also for making wide-ranging management decisions that affect the facility’s risk management, efficiency, and productivity.

The day-to-day duties of running an ASC are complex and time-consuming, and ASC managers and administrators need ongoing support from an accounting and financial services provider they can trust completely. MedHQ earns this confidence from clients by providing timely, thorough, and accurate financial reports, as well as detailed analysis and expert advice geared toward maximizing their business performance.

The MedHQ accounting team’s goal is to focus on the business side of running an ASC, so surgery center management can focus on their patients. MedHQ’s healthcare accountants have decades of experience in the industry and understand every step of the healthcare revenue cycle. With services tailored to each client’s specific needs, MedHQ’s accounting team acts as trusted advisors to their clients.

The MedHQ accounting team offers ASC clients an accurate, up-to-date picture of their financial affairs. But they go beyond that in their services, paying close attention to important details that might be overlooked, and staying on top of key metrics that aren’t always tracked.

These accounting services help clients reduce their risk, increase their revenue, and save money by avoiding expensive errors, discovering cost-saving opportunities, and improving everyday efficiency. By leveraging their extensive knowledge of the healthcare revenue cycle, MedHQ helps ASC leaders make informed decisions about their business.

The due diligence MedHQ specializes in has a proven record of uncovering significant savings. In one case, they discovered that while a client was making payments on a large loan, the lender made a serious mistake in the payment schedule. The lender had calculated the wrong amount for the balance due – and their meticulous investigation into the error saved the client $300,000. In another instance, MedHQ unearthed a large number of old accounts that their client had not collected on. Due diligence revealed shortcomings in the ASC’s overall AR process and led to the collection of approximately $100,000 that would have been written off otherwise.

Learn more about the benefits of finding a trusted financial partner.

Download the full guide: Improving Business Performance Through ASC Accounting Expertise

3 Touch Points to Better Engage a Multi-Generational Workforce | MedHQ Blog

3 Touch Points to Better Engage a Multi-Generational Workforce

As average retirement age climbs with the health, vitality and economic necessity of the Baby Boomer generation today, many ASC leaders are challenged to manage a workforce that includes employees age 18 to 80. Motivating workers across a multi-generations – including Boomers, Generation X, and Millennials, each with distinct attitudes about work and career – takes finesse, and a solid understanding of differing experiences and expectations.

“Getting the best from an age-diverse workforce means finding ways to engage each employee in a way that is meaningful,” says Tom Jacobs, MedHQ’s Chief Executive Officer.  “Managed well, a multi-generational workforce can infuse an organization with the wisdom of experience and the energy of new ideas, to achieve more success than would ever be possible with a homogeneous workforce.”

‘Managing well’ is the challenge, however. While employees of any age want to be engaged at work and to enjoy success against specific career goals, research suggests real differences in the concerns and needs, learning styles and life goals of employees from different generational groups. To help ASC leaders optimize productivity from today’s multi-generational workforce, MedHQ advises a shift in management mindset from ‘boss’ to ‘coach,’ and offers three touch points to guide effective leadership.

Diversify Training

Many studies point to differing preferences for training across generational groups. One such report, “Tapping into Talent,” published by The Chartered Institute of Personnel and Development (CIPD), suggests Millennials and Generation X preferring independent, online training resources, while Baby Boomers and Veterans prefer more traditional classrooms and books. In an ASC environment, using a mix of both training approaches can help improve the capabilities of individuals while strengthening teams, creating an environment of continuous learning, initiative, and innovation.

Jacobs says MedHQ’s own research underscores the importance of changing the conversation about goals for training, especially when it comes to Millennials (but increasingly for Boomers working hard to stay current, too) to focus on ongoing development rather than a more static approach geared toward job satisfaction.

“Every employee is different, so one goal of training should be to identify and develop those differences, to enable the full potential of each employee,” Jacobs says. “There are generational differences in the way people learn best, but in general, training that takes people a bit outside their comfort zones and helps them stretch makes workers feel engaged and supported in their growth.”

Accommodate Work/Life Styles

Millennials’ penchant for workplace flexibility, work/life balance and career growth opportunities, even over financial rewards, is well documented. But when it comes to managing an effective multi-generational workforce, these kinds of cultural “perks” can help engage workers of any age. According to Jacobs, shifting the conversation from being concerned with an employee’s job or career to one of concern about their whole life is an effective way to coach Millennials, and appeals to other players in the workforce as well.

“If we can overcome our unconscious bias about age; if we can stop thinking of Millennials as ‘tech-obsessed,’ or of older workers as ‘stuck in their ways,’” we take big strides toward an effective, multi-generational workforce,” Jacobs says. “The key is to create a culture for all that encourages workers to be themselves, and helps them feel valued and challenged, trusted to pursue both organizational and personal goals, with freedom to experiment, fail, and grow.”

Rethink Performance Management

Traditional performance management systems, centered on a set of pre-determined goals and an annual review, are less effective with a multi-generational workforce. Instead, companies like GE, Adobe, Accenture, IBM have found that moving to an approach focused on real-time feedback is more motivational and in tune with employee’s needs in today’s world.

For ASC leaders, Jacobs says rethinking performance management may mean seeing each employee as an individual, and encouraging ongoing dialog about how he or she is doing in roles that fulfill the ASC’s mission. Empowering functional managers to coach each individual on both personal and organizational objectives can bring more focus to the areas of contribution each employee enjoys most, and result in the best use of their strengths.

For more information about MedHQ’s business services to guide ASC human resources policies, procedures and programs, click here.

Developing Top ASC Talent | MedHQ Blog

For ASC Leaders, Developing Top Talent Pays: Cost-Savings, Efficiency, and Marketing Benefits

Identifying and providing constructive career development opportunities for your ASC’s top performing employees can be one of the most cost-efficient ways to ensure success for your organization in today’s complex healthcare environment. Cultivating the “A” players on your team is a key strategy to help meet staffing goals, improve employee communication and knowledge sharing, and bolster your ASC’s image in the marketplace.

“Every HR professional understands the importance of keeping employees challenged and growing,” says Tom Jacobs, CEO of MedHQ, “but having a focused, purpose-driven strategy and program for developing your best performers is a powerful driver of several of an ASC’s most important business metrics.”

Jacobs outlines four key business advantages to such a strategy:

  • Retention & Succession: While most ASC leaders understand the need to retain top talent, the “how” is more difficult. Providing visible and specific career development opportunities helps top performers stay motivated, and encourages them to look within the organization when they need a change or a new challenge – rather than elsewhere, creating succession planning options.
  • Cost Savings: Improving the effectiveness and satisfaction of your ASC’s top performers also can result in significant savings, both on the hard costs of turnover, and on associated “under the radar” expenses like the loss of company knowledge, disruption of customer service, and reduced morale and engagement among remaining employees.
  • Closing Skill & Role Gaps: As the demands of leadership in healthcare become more complex, competency gaps are more common. Nurturing top talent is one way to create a culture and process that enables qualified employees to find roles best suited to them, filling the gaps without the more extensive costs associated with hiring, training, and onboarding outside hires.
  • Brand Building/Recruiting: An effective career development initiative creates a positive buzz for an ASC in the marketplace that can help recruit new talent as well, leveraging happy, challenged employees as brand ambassadors.

So how do you go about implementing a strong program for developing “A” Players? Jacobs suggests working with them on four career development fronts:

  • Education: Many researchers have uncovered the Millennial generation’s penchant for quality training. ASCs can support top talent with personalized investments in the learning they care about – such as technical or management classes, or even attendance at industry conferences – filling skills gaps for the individuals and the organization at the same time.
  • Job Scope: Expanding their responsibilities within their function is another way to challenge your “A” players, growing their capacity as leaders.
  • Increased Breadth: Or, challenging your “A” player beyond their function is a great way to increase their knowledge of the ASC’s business overall, and to introduce them to experts across the organization.
  • Mentoring: Pairing top performers with senior leaders as mentors exposes them to the roles you eventually want them to grow into, and opens doors to the relationships they’ll need to get there. The process can be helpful to the leaders as well, keeping them in touch with the ideas and energy of the ASCs top talent.


Click here to learn more about MedHQ’s HR strategies designed to drive ASC success.

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