I think one of the qualities that a good credentialing professional must have, is the ability to be resourceful. The ever-changing landscape of healthcare has disabled the field of credentialing and made regulatory and process training scarce. Education is needed for all of those effected by credentialing outcomes. It is needed for credentialing professionals, who are doing the work on behalf of the providers and their companies. It is needed for the providers themselves, who see it as a headache that only lingers. Education is also needed for the executives and administrators who need the credentialing process to run a successful business.
There is a lack of leadership and interest in the field, because of the pressure to get the process completed so quickly and with such high volume. Hospital administrators want providers to be hurried through the credentialing process and obtain board approval, so they can start seeing patients and performing surgeries. Corporate executives want enrollment credentialing expedited so that they can start billing for the provider's services. With these motivations, it is no surprise that credentialing is viewed as the roadblock; the bottleneck; the red tape; the bureaucratic nightmare.
Credentialers are the gatekeepers. A gatekeeper's precision and attention to detail provides an opportunity to allow only the qualified, healthy providers to care for patients. It is a process that eliminates the possibility for providers who could (and may already have) caused harm. Dollar signs lead us through the landscape of healthcare. As they illuminate the path we take, there is a greater challenge to shine the light on the value of credentialing.
What do we do about it? As credentialing and medical staff professionals, we dig into the part of us that knows why we do, what we do...and we become more resourceful. We strive to put efficient mapping processes in place to ensure that the credentialing and enrollment runs smoothly and according to the standards from the regulatory bodies. As gatekeepers, we strive for frequent communication, while providing education to providers, administrators, executives, ourselves, and payers for successful outcomes.
The first step is recognizing our role. Educating ourselves on best practice protocols and helpful tools will allow us to meet reasonable deadlines while satisfying the needs of healthcare organizations. Gatekeepers, mount up...Who's with me?