For numerous MSPs, provider enrollment is becoming an increasingly familiar topic. According to the 2018 MSP Salary Survey Report, approximately 30% of respondents who work in the medical staff services department also handle provider enrollment. Although that means 70% of MSPs do not currently...
As the aging population increases, the physician workforce decreases, and reimbursement rates struggle to keep up, many organizations are seeking cost-saving solutions wherever possible. One way to achieve that is to consolidate services where it makes sense to, and MSPs and provider enrollment...
Most medical staff bylaws contain a provision concerning the categories into which the medical staff will be divided. In fact, many medical staffs have created an unnecessarily complex array of categories. Many of these categories were created 20–30 years ago as medical staffs tried to...
Credentialing Resource Center Journal - Volume 28, Issue 9
A Massachusetts District Court (the “Court”) denied the motion to dismiss put forth by Massachusetts General Hospital (MGH), Massachusetts General Physicians Organization, and Partners Healthcare System (collectively, “Defendants”). Defendants based the motion on the plaintiff’s failure to state...
Credentialing Resource Center Journal - Volume 28, Issue 9
Plus, anesthesiologist billed $7 million for fraudulent telemedicine services, nurses in Tennessee fight for less physician oversight, and District Court in Oregon approves $74 million settlement after Premera Blue Cross breach. Find out what’s happening in the world of federal healthcare...
This past July, the Massachusetts Board of Registration in Medicine unanimously passed two new rules aimed at further regulating overlapping surgeries to optimize patient safety in the operating room. As defined by Massachusetts General Hospital (MGH) in Boston, overlapping surgery, sometimes...
Credentialing Resource Center Journal - Volume 28, Issue 9
I had just completed my case presentation on provider master data management (MDM) at a conference for medical professionals. A well-suited executive came up to me and asked me, “Our mergers and acquisitions are moving at a rapid pace; the other teams can’t keep up. Can master data help?”
Since June 2018, the medical staff services department at Indiana University (IU) Health Bloomington Hospital has conducted a well-received new provider orientation (NPO) program. NPO is scheduled every Monday and Tuesday and canceled when it is not needed. Leaders are responsible for making...
Credentialing Resource Center Journal - Volume 28, Issue 9
Accreditation organizations require medical staff services departments to perform ongoing professional practice evaluations to assess the competency of providers granted clinical privileges, including APPs, on a continual basis.The OPPE process relies on MSPs’ ability to collect clean data that...
The Centers for Medicare & Medicaid Services (CMS) has established the Conditions of Participation (CoP), which are the absolute minimum set of requirements that all hospitals must meet to participate in federal payment programs. CoP s require that there be an organized...
