By Allyson Schiff
COVID-19 has caused extraordinary financial and clinical stress for already strained healthcare organizations. For the first time in history, hospitals and health systems across the country were forced to cancel elective surgeries and non-emergency services. According to the American Hospital Association, for some, the cost of cancellations accounts for up to 75 percent of lost revenue.
The pandemic has also triggered a variety of workforce challenges. With an unprecedented number of healthcare professionals furloughed, some nurses and non-medical staff are moving on to other opportunities. The current physician shortage is also predicted to worsen. A June 2020 reportby the Association of American Medical Colleges (AAMC) notes physicians intend to retire earlier than was assumed in previous supply projections.
In an environment where every dollar truly matters, hospitals and health systems cannot afford to wait months for a new provider to start seeing patients. Accelerated provider onboarding and accurate and timely reimbursements must be a priority. This is especially true considering, on average, a physician/surgeon generates $2.4 million annually for their affiliated hospitals.
Understanding provider onboarding issues and how to resolve them is essential in these turbulent times. Here are four considerations to get started on the path toward accelerated credentialing.
1Take a team approach.
Onboarding is the journey to bring a provider to the point of being able to see patients and receive reimbursement. It is a complex, tedious process that starts with HR during recruitment, and spans multiple departments including contracting, credentialing, privileging, and enrollment. Because these departments typically work independently and utilize unique systems (e.g., manually working in an Excel spreadsheet or basic technology), there is little collaboration. And if information is shared between departments, it is not done in an automated, coordinated fashion. Meanwhile, poor communication and collaboration causes unnecessary delays, inefficient workloads, lost revenue, and provider frustration.
Identifying and eliminating bottlenecks in provider onboarding is essential to accelerating the processes required for providers to see patients and receive accurate, timely reimbursement for the care they provide. This requires breaking down silos so that each department works in unison to onboard a provider. Every downstream process—credentialing, privileging and enrollment—should start the moment a contract is signed.
2Centralize data and documents.
With so many moving parts and even more data, a single source of truth ensures that everyone involved in provider onboarding has access to a real-time view of pertinent information. Role-specific workflows and real-time monitoring of a provider’s position at every stage of the onboarding process make it easier for each department to know what should be done on a day-to-day basis. Cross-department transparency and sharing of data and documents greatly minimizes the likelihood of something falling through the cracks, ensuring system compliance.
Beyond efficiency gains, provider frustration is avoided when a single request for data and documents is made instead of multiple departments repeatedly asking for the same information.
3Utilize intelligent technology.
While there is great value in a centralized repository, that alone is not enough for true accelerated onboarding success. Intelligent technology with artificial intelligence (AI)-powered analytics eliminates guesswork by guiding users through specific processes. Data standardization enforced by dynamic validation and role-driven access to data dictionaries minimizes manual errors with downstream effects. In addition to streamlining processes and avoiding compliance issues, a guided, cross-department workflow eliminates unnecessary reimbursement delays caused by siloed and legacy technologies. It also increases the accuracy and completeness of provider data.
4Don’t underestimate the value of information.
Onboarding problems are not a surprise; every hospital knows they exist. And while it’s common knowledge that onboarding “takes too long,” without an aging component and the ability to identify precisely where bottlenecks are occurring, there is no way to engage in corrective action.. For example, a radiology department takes twice as long as the pathology department to privilege a provider. If a system does not track activities at the time, date, and user level and allow for reports to be automatically driven from this data, it’s impossible to identify where the gaps occur. And without a way to identify an issue, it’s impossible to repair.
Diagnosis is an important part of provider onboarding, yet it is often overlooked or impossible because comprehensive technology and reporting capabilities are not properly in use. Meanwhile, delays continue, and providers are left in limbo unable to see patients. It’s easy to get overwhelmed by too much data, but data-driven insight reporting provides more than a running list of various elements – it provides information.
The path to accelerated onboarding is much more than deploying software. A whole new process for uniting multiple departments must be created. Each hospital and health system has its unique needs, so each journey is unique. Guided implementation and customized training (and re-training whenever needed) significantly lessen the burden and are key to ensuring that everyone involved in the onboarding process is comfortable with the system and sees the true value of the technology.
Hospitals and health systems can no longer accept provider onboarding issues as simply “par for the course.” Breaking down silos and accelerating provider onboarding with intelligent technology and services brings providers and patients together faster and improves the revenue cycle, which is essential in today’s environment of razor-thin operating margins and long-term financial distress caused by the COVID pandemic.
Allyson Schiff is Senior Director, Strategy & Growth, Provider Management at TractManager.