If you are anything like me, you are already wishing away winter. The only way I will get through the next few months of snow and sub-zero temps is by thinking about Spring, sunshine, and trips to the beach. Luckily this winter, I also get to think about going to Las Vegas in March for the CRC Symposium. Even though March feels many cold days away, now is the time to plan your trip and register for this event. Not only will it give you something to look forward to over the next several months, you will also get the special early bird discount rate.
On a related note, I would like to congratulate our first winner of a free seat to the CRC Symposium, Monica Bilecky, CPMSM, CPCS, credentials manager for David Grant Medical Center at Travis Air Force Base. Along with many of you, Monica visited the HCPro booth at NAMSS and won our raffle. We are currently raffling another free registration to participants in our HCPro Medical Staff Book and Webcast Survey. To enter that contest, click here and complete the survey. Make sure to enter your contact information so you can be entered into the drawing.
To read more about the CRC Symposium, featured speakers, and agenda topics, click here. And continue to check back on the blog for more information about the symposium, including interviews with our speakers.
After two nurses at Texas Health Presbyterian Hospital in Dallas were infected with Ebola while treating a patient with the virus, the CDC released stricter infection control guidelines for healthcare workers focused on personal protective equipment (PPE).
The CDC’s updated guidelines make the following recommendations when caring for a patient with Ebola:
- All healthcare workers undergo rigorous training and are practiced and competent with PPE, including putting it on and taking it off in a systemic manner
- No skin exposure when PPE is worn
- All workers are supervised by a trained monitor who watches each worker putting PPE on and taking it off
The updated guidelines are modeled on those used recently by Emory University Hospital, Nebraska Medical Center, and the National Institutes of Health Clinical Center to treat patients with Ebola. No healthcare workers at these facilities have contracted Ebola.
Do you struggle with explaining/helping newly-minted physicians through the credentialing process? Does this sound familiar:
Although physicians who complete an ACGME-approved residency come out of that program trained to provide patient care within their specialty, they are not equipped to handle the major paperwork and administrative processes associated with application to the myriad healthcare organizations and healthcare plans to which they will apply. Although there may be administrative staff to help with completing these applications, the physician must initially provide the information to the support staff.
Physicians also need to know what the credentialing and privileging process entails and how they can best help with getting all the necessary documentation they need to go along with the application. The sooner a physician gets on staff at a hospital or on the panel of a health plan, the sooner he or she can begin generating revenue. Many times, the process is held up due to late applications or applications that lack sufficient information.
HCPro is working on a book and needs your help. Do you think a book describing the credentialing process to physicians would make your job easier? If so, what would you like to see included in this book? If you don’t want to respond in the comments, feel free to email me directly: firstname.lastname@example.org
Thanks for your help!
I’ve been poring over my notes from the 2014 NAMSS Educational Conference and Exhibition, and discovered a quote from Hugh Greeley’s Tuesday presentation, “This is What We Live For: Effectively Dealing with Our Most Complex Applicants and Re-Applicants,” that stands out. Describing the MSPs’ role in protecting the patient, facilitating clinical practice, and supporting organizational improvement, Greeley said, “You don’t live for validating the licensure or processing the paperwork … you live to make it better.”
In a three-day span that offered so much MSP and medical staff leadership insight, and plenty of other words to live by, his statement resonated because it acknowledges the medical staff services department’s potential contributions to process improvement. The goal is to create and execute the best processes possible—but changes are often necessary, there’s always room for improvement, and MSPs are in a unique position to influence that improvement. Greeley also noted that it can be better to influence than to command.
If your medical staff leadership listens when you ask the questions that can move care forward at your organization, I’d like to know. And if you were at the NAMSS event this week, was there one educational session that stuck out for you? I’d be interested to know about that, too.
Thanks for reading!
Opening remarks by outgoing NAMSS President John Pastrano, BBA, CPCS, CPMSM, director, of medical staff services at Centennial Medical Center in Frisco, Texas, who noted that the 2014 event drew a record number of attendees, estimated at 1,500, and a virtual audience of nearly 600. In addition, NAMSS’ membership is on track to hit 5,200 this year, he said.
Keynote speech by David Nash, MD, dean of the Jefferson School of Population Health in Philadelphia. Nash observed that medical staff services departments are the guardians of the gate of accountability and transparency. Changes in healthcare that emphasize transparency and accountability mean providers and systems are all going to be “naked,” in a figurative sense. And “if you’re naked, you’d better be buff,” he said.
The first copy of the latest edition of Verify and Comply, hot off the press and on display at the HCPro booth in the Exhibitor’s Hall. If you’ve ordered a copy of the new edition, it should be arriving shortly. If you haven’t, click here for more information.
If you’re in New Orleans, take a minute to stop by the HCPro booth tomorrow, say hello, and see what we’re up to.
Thanks for reading!
If you’re attending the NAMSS 38th Educational Conference and Exhibition next week in New Orleans, what are you looking forward to the most? Is it the keynotes? The sessions and panel discussions? Maybe the networking opportunities? The camaraderie of hundreds of people who know what you do and how challenging it can be? “All of the above?”
I hope to see you there, either during the presentations or in the exhibitors space. Stop by the HCPro booth and say hello. It’s been a busy year the Credentialing Resource Center and we’ll showcase some of our Credentialing and Medical Staff resources while we spread the word about what’s in store for 2015 … including the reinvigorated CRC Symposium in March!
Now it’s time for me to take care of some pre-travel details. But if there’s a do-not-miss item on your NAMSS New Orleans agenda, let me know.
Thanks for reading!
Verify and Comply, Credentialing and Medical Staff Standards Crosswalk, Sixth Edition, combines both credentialing and medical staff standards and regulations into one easy-to-navigate manual, giving MSPs one book that answers all their accreditation questions. This expanded guide includes CMS, Joint Commission, NCQA, DNV, HFAP, and AAAHC standards side by side in an easy-to-read grid.
Subject matter experts Carol S. Cairns, CPMSM, CPCS, and Kathy Matzka, CPMSM, CPCS, have compiled a one-stop resource for answering your acute care, managed care, and ambulatory care medical staff/credentialing questions.
This side-by-side compilation of accreditors’ standards will help you:
- Understand the differences between the stages of the credentialing process: appointment, reappointment, and ongoing assessment
- Determine which verifications are necessary to obtain in the credentialing process
- Assess ambulatory standards for your ambulatory facilities
- Define the structure of your medical staff and its responsibilities
- Determine the appropriate area in medical staff governance documentation to include specific items required by accreditation standards and regulatory requirements
- Explain your medical staff’s involvement in organizational leadership functions
Click here for more information and thanks for reading!
Mark your calendars for March 12-13, 2015, for the return of the Credentialing Resource Center Symposium! The event will take place at Caesar’s Palace in Las Vegas. We have a great group of speakers lined up: Carol S. Cairns, CPMSM, CPCS; Hugh Greeley; Sally Pelletier, CPMSM, CPCS; and Todd Sagin, MD, JD.
In the weeks to come, keep your eyes open for more information about the symposium and interviews with the speakers appearing in the Credentialing Resource Center Insider and Medical Staff Leadership Insider e-zines, on this blog, and in the Credentialing Resource Center Journal and Medical Staff Briefing newsletters. For information about the symposium, click here. We hope you can join us next year in Las Vegas!
Stay tuned, and thanks for reading.
If your bylaws are silent on important issues, contain contradictory guidance, or suffer from years of obvious cutting and pasting, plan to tune in Wednesday, October 29, from 1:00 to 2:30 p.m. Eastern Time for help bringing these vital documents into the 21st century.
During a 90-minute webcast titled Medical Staff Governance: The Increasing Importance of Contemporary Bylaws, presenter Todd Sagin, MD, JD, will offer a roadmap for assessing bylaws and documents to determine if a simple update or complete overhaul is needed. Dr. Sagin will also discuss the steps to take that will allow medical staffs at any facility to create reasonable timetables for review and revision.
In addition to learning about the roles of MSPs, medical staff leadership, committee chairs and others in the bylaws review process, webcast attendees will be able to:
- Address common hot-button issues that create liability
- Apply best practices to the contents of contemporary medical staff bylaws
- Prepare an effective approach to the review and revision of current medical staff governance documents
Ample time for Q&A will be provided for you to get your questions answered by Dr. Sagin, who frequently assists hospital boards, medical staffs, and physician organizations in their efforts to create or revise bylaws documents.
Click here to learn more about this webcast.
As always, thanks for reading!
Hospitals are federally mandated to query the National Practitioner Data Bank (NPDB) when an eligible practitioner applies or reapplies for medical staff appointment or clinical privileges. “A hospital may not delegate its own responsibility to query or credential practitioners because of the federal requirement that hospitals must query. A hospital’s query must be submitted to the NPDB either directly by the hospital or through the hospital’s authorized agent,” the NPDB states.
The differences between delegated credentialing entities and authorized agents can be confusing, but in the September online issue of Data Bank News, the NPDB provides a side-by-side comparison/explanation (as well as the bolded text in each field):
|An entity selects an authorized agent to report and/or query the NPDB on its behalf, without making credentialing decisions. The authorized agent simply performs the assigned tasks.||An entity gives another entity the authority to
make final credentialing (i.e., hiring or privi-
leging) decisions, such as when a health plan
uses a hospital’s credentialing decision as the
basis for permitting a practitioner to partici-
pate in its network.
|An entity that uses an authorized agent to report and/or query on its behalf still retains responsibility for making credentialing determinations for its practitioners.||The entity that delegates credentialing is not
considered part of the credentialing process
and is prohibited from receiving NPDB query
|Hospitals may not delegate their responsibility to query because of the federal mandate for
hospitals to query the NPDB when a practitioner applies for a medical staff appointment or
clinical privileges and every two years thereafter. Health plans are the most common
delegators of credentialing, most often to hospitals.
Check out the NPDB page for more information about the differences between delegated credentialing entities and authorized agents.
And as always, thanks for reading!