Ambulatory credentialing: Bolster staff expertise
Compared to the average hospital, ambulatory facilities have much shorter rosters of affiliated practitioners, meaning a lone employee may constitute the entire credentialing workforce. Sometimes, practitioner vetting isn’t even that employee’s primary focus or area of expertise. “You usually don’t have a full-time MSP working in a place like that, so therefore they may not be up to speed with what’s required for credentialing and privileging,” says Kathy Matzka, CPMSM, CPCS, FMSP, an independent medical staff consultant in Lebanon, Illinois. She points to credentials verification organizations as one solution for overcoming such expertise deficits.
For facilities intent on keeping the credentialing function in-house, consider distributing the burden among several capable team members. “If I were an administrator of a center, I would elicit help from someone who works there and not try to put this all on my shoulders,” says Cathy Montgomery, RN, CASC, president and managing partner of Excellentia Advisory Group, LLC, a consulting firm for ambulatory surgery centers and physician practices in Saint Peters, Missouri.
While leadership may want to retain control of key decision-making processes, Montgomery recommends offloading some of the time-consuming administrative tasks, such as verifying that aspiring affiliates have submitted complete applications, assembling files, and keeping track of key deadlines, including privilege expiration dates. Team members who take over these responsibilities should be detail-oriented and up for a challenge, Montgomery says.
While rebalancing the credentialing load can be beneficial, be careful not to disperse functions among too many stakeholders. When it comes to credentialing assignments, consistency begets competency.
“Don’t put credentialing on a duty roundtable,” says Marshall Baker, FACMPE, president and CEO of Physician Advisory Services, Inc., a consulting firm for physician practices in Boise, Idaho. “If John or Susie are doing credentialing this year, and presuming they stay with the organization, that should become a continuing job for them so they know the process.”
To foster consistency on a larger scale, multisite organizations should consider developing a standardized training program to fortify staffs’ fundamental credentialing knowledge. For example, Matzka worked with an ambulatory surgery center system to develop an on-demand training and ancillary materials covering credentialing best practices and AAAHC standards, which the organization now uses to train staff across its 150 locations.
Beyond building a strong foundation of credentialing expertise, ambulatory facilities should regularly evaluate and fine-tune their vetting approaches. Consider using the AAAHC report as a lens for assessing current strengths and weaknesses, says Matzka. Regardless of how your organization measures up, frame findings with appreciation and optimism.
“If [credentialing stakeholders are] doing a good job, give them a pat on the back. If there are areas where they need to do better, this would be a learning opportunity,” says Matzka. “Show them that we’re not the only ones that have problems with this—we can all do better.”