On Wednesday, June 20, 2018, VantagePoint HealthCare Advisors President and COO Susan Prior, CHC and Senior Consultant Regina K. Alexander, FACHE, CHC presented a live webinar, The Unknown-Unknowns of Credentialing, Privileging, and Enrollment for the Health Care Compliance Association (HCCA). The webinar drew a diverse audience, including attendees from hospitals, health systems, health plans, post-acute care, law and consulting firms. During the Q&A portion of the event, we responded to many questions; however, time ran out with questions still pending in the queue. HCCA has provided VantagePoint with the list of unanswered questions. We'll base some of our upcoming posts on these questions.
Our first unanswered question from the webinar centers on tactics to gather the data and documents necessary to credential and enroll new providers. The attendee queried, "Do you think a robust credentialing process is as manageable as we would like it? Despite changing around the wording of my welcome letters for providers they tend to miss many data points I need to properly credential and to pass along this info to eventually enroll with health plans."
Yeah. This one is tough! The questioner has already attempted to streamline his/her process by revising the welcome letter sent to new providers. While revising the letter is an approach is absolutely on VantagePoint's to-do list, and electronic applications are available to help with tracking, we'd suggest taking another look at the letter and consider the following:
- How long is the letter? This is the time to be succinct to avoid losing the new provider's attention or muddling the message.
- Avoid over-explaining. The letter should open with a welcoming sentence followed by a statement regarding items required to credential/enroll. Consider a polite, yet to the point sentence explaining the most compelling reason for timely and complete submissions of the information requested.
- Consider an even shorter letter per the previous bullet point with a checklist attached. People generally like the feeling they get from checking items off a long to-do list, so this may motivate the provider toward completion. The checklist should include all items needed to complete the credentialing & enrollment process, perhaps a brief description or specific requirements statement for each item if potentially confusing, include a box to check-off the items (like a shopping list), a box for the provider to write comments and a place for the provider to sign-off/date that all items requested are enclosed.
- Provide an email address and phone number for questions. Welcome questions from providers during the process and be ready to explain the 'why' we need all this stuff types of questions.