The untapped potential of MSPs and provider enrollment

Despite the clear competency crossover in medical staff services and provider enrollment, not everyone is taking advantage of the alignment opportunities. Over half of respondents to the 2017 MSP Salary Survey (55.6%) who work on teams that facilitate medical staff services report that, while their organization also performs provider enrollment, those services are handled by a different department.

“It still seems to be divided up at most hospitals and health systems,” says William K. Cors, MD, MMM, FAAPL, senior medical director of Lehigh Valley Health Network in East Stroudsburg, Pennsylvania. “I would have thought that, with time, since this is such a subject matter expertise of credentialing and privileging people, most hospitals and health systems would wake up and realize that they already have an army of people in their organizations that can do payer credentialing for them. They don’t need to go out and hire other people.”

The uneven uptake stems, in part, from a pervasive misunderstanding about what credentialing actually entails, says Cors. As every passionate MSP knows, the medical staff services profession supports numerous big-picture healthcare goals, including patient safety, risk management, and revenue integrity. By ensuring applications reflect a practitioner’s true clinical background and flagging potential discrepancies that could spell trouble down the road, MSPs protect patients, practitioners, and their employing organizations on a daily basis. However, these organizationwide gains can be overshadowed by the intricate—and often lengthy—process of rigorous credentialing, which, to the untrained eye, can seem like little more than a bureaucratic obstacle to swift onboarding of the institution’s top money makers.

“Unfortunately, a lot of times, the hospital C-suite views medical staff professionals as a bunch of paper pushers who slow down bringing on revenue-producing practitioners,” says Cors. “Now, that is not the truth. The truth is they’re actually doing a fundamentally important piece of work for the organization in making sure that everybody who visits the organization is qualified to be on the medical staff or to have privileges at the hospital.”

Source: News & Analysis