Providing quality healthcare to your patients and community is the key objective of any physician and healthcare provider. As the U.S. patient population continues to age, the need for more clinical expertise has mushroomed. The increasingly complex dynamics of the healthcare industry is prompting many providers to pursue alternative careers. These factors can create an emergent need to fill clinical positions quickly — sometimes too fast!
The medical staff and payer enrollment process have improved in recent years. However, it’s still imperative that every person from the recruiters to the front desk staff understands the start-up timeline and the importance of taking appropriate steps to ensure all new providers will be paid for the services they render. Allowing a provider to begin seeing patients before they are properly credentialed is an intentional decision to provide services for free. If that’s okay with the parent organization, it should be tracked so that this loss can be quantified.
The orientation of each new physician/provider is critical to providing baseline education about the expectations of the organization. This applies to productivity levels as well as billing, coding, and compliance requirements. These expectations should be outlined during the recruiting process as well. However, many organizations shortcut this part of the process and hire providers who have poor billing and coding habits, which exposes the new organization to higher risk. Clearly communicating the productivity expectations of each new provider should be done at the onset of employment. Providers should be aware of what it takes to break even, cover their costs, and become profitable.
Initiating a new provider schedule to optimize provider and staff time requires frank discussions about patient access to care coupled with productivity expectations. Building a timeline to allow a ramp-up for the provider and staff is sometimes bypassed because of increased patient access needs. Alterations to the standard schedule should be avoided, so that patient expectations are met and/or exceeded. A review of the credentialing/enrollment process typically results in the discovery of significant gaps in the process. Quantifying the impact of these gaps by tracking the associated financial losses is an effective way of communicating this information to senior leadership. Outlining your enrollment and credentialing timeline is the first step to understanding the necessary measures in a successful recruiting effort. Coker Group can assess your enrollment and onboarding processes to provide recommendations about the steps required to be paid for all provider services rendered.
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