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.
- 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.
- 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.
- 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.
- 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.