We Need to Drive Change for Improved Credentialing

The complicated process of healthcare provider credentialing has long been an industry-wide headache for healthcare providers. From locum tenens (temporary physicians) to permanent physicians, the credentialing process can test the patience of even the most seasoned providers. Yet, as we know, it’s necessary for providers to work and get paid, and for patients to safely access care from qualified physicians. Dr. Edwin Leap wrote a piece recently for MedPage Today summing up the challenges that he has routinely faced as a physician trying to practice medicine amidst the red tape consistent with credentialing. And these challenges are not unique, as almost any provider will tell you.

In the article, Dr. Leap refers to what he calls status credentialus” to put a name to the many hindrances of provider credentialing. “…this “status credentialus,” this endless inefficiency, is going to have a price sooner than anyone thinks. Because we’re running out of physicians, about half of whom in America are over the age of 50. Many others are leaving their jobs early to change careers or to retire as soon as possible,” explains Dr. Leap. 

“The reasons are many, but we’ll eventually be fresh out of doctors willing to do the work. I don’t just mean the ever-more-difficult work of medicine, but the painful, all-consuming, and uncompensated work of credentialing. And if we should — heaven forbid — face another COVID-like crisis, we won’t be able to wait half a year for doctors to go to work … if doctors even remain.”

Credentialing isn’t going anywhere (nor should it) but the process needs to be improved and soon. An automated cloud-based credentialing platform, such as Modio’s OneView is a must. This type of technology can remove the headaches that accompany credentialing and allow for quicker approvals so providers can start working faster. Partnering with an expert credentialing team is also valuable. You will work with a team of people well-versed (that eat and sleep credentialing) to help providers navigate the many intricacies of credentialing. You’re also leveraging people that have built substantial relationships with payors, hospitals, and others that can help move things along more quickly.  

The idea of creating “a single source of truth” to create a more universal landscape of the process is also important. By specifically examining provider credentialing, pulling primary-sourced and accurate data into a system that also feeds data out to other systems is critical. A single source of truth allows all this data to flow into a centralized database that is updated in real time and is bi-directional. 

“A system like this does not exist today, but it should be the goal,” says John Bou, Modio’s COO and co-founder. “Across the sector, it’s difficult to share data due to a lack of common language and a lack of trust in where the data is coming from. Organizations are using technology to bridge this gap. If we apply this strategy to provider credentialing, all stakeholders (such as licensing or provider enrollment) can quickly access the data from one single location.” 

With healthcare’s persistent and growing issues including provider burnout and an alarming healthcare workforce crisis – it’s essential we prioritize credentialing solutions that will ease up administrative pressure on providers, ensuring they are not only freed up to practice medicine when and where they are needed, but have more time with patients. 

Learn more about Modio’s Credentialing Platform today. 

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