'CredentialingSpectrum', A complete credentialing profile module by Clinicspectrum

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"CredentialingSpectrum' is a software that manages credentialing and re-credentialing activities as well as Insurance Participation Agreements. Other Features of 'CredentialingSpectrum' include: * Management of Credentialing and Re-credentialing activities and reminders. * Complete Cloud-based Documents Management for Credentialing Documents. * Reminders on Expiration of various credentials such as CDS, DEA, License, CAQH, Board Certification, Mal Practice, Hospital Privileges. * Facility Credentialing Management. * Milestones Management. * Insurance Participation Agreements and/or Contract Management * Auto-fax, Auto-email and Secure Messaging Capability. * Extensive Report and/or analytics Module. ** 'Clinicspectrum' is healthcare services company providing outsourcing and back office solutions for medical and hospital billing companies and medical records. KNOW MORE: http://clinicspectrum.com/credentialingspectrum.html Website: http://clinicspectrum.com/

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Contact Us
2222 Morris Ave. 2nd Floor,
Union, NJ-07083
Website
http://clinicspectrum.com/
Phone Number
908.834.1608
Email
info@Clinicspectrum.com
Clinicspectrum is a healthcare services company providing outsourcing and back office
solutions for medical billing companies, medical offices, hospital billing departments, and
hospital medical records departments.

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We have been hearing a lot that Future of Medicine is “Patient Centric”. Patient Engagement is crucial for clinical and financial outcomes. I have observed that almost 50% of articles or whitepapers are talking about Patient Engagement either through Technology (or) proactive interactions. I would like to draw a parallel between “Customer Engagement’ and “Patient Engagement”. It is essential to have accessibility, accountability and assurance for products and services sold by the company for customer engagement. This principle of business is equally true for “Patient Engagement” as well. Let’s look the role of Accessibility, Accountability and Assurance in creating Patient Centric Medical Practice or Patient Engagement. • Accessibility. Accessibility refers to the quality of being available when needed. Patient Engagement starts with the “Accessibility” factor of the medical practice. How many times does a patient need to call the office in order to get answers for his/her questions? How soon can a patient find an appointment when they don’t feel well? Can a patient pick up the phone and reach out to his/her doctor on the weekend, with ease? How soon do patients hear back from the office staff in regards to their referral (or) authorization requests? The above questions define accessibility factor in patient engagement. Several providers are concerned about clinical compliance and medication adherence by their patients. However it is observed that both of these are achieved easily if the patients don’t have to make several calls to reach their clinical coordinators or physicians. • Accountability. Accountability is nothing but an obligation or willingness to accept responsibility. This simple word defines a lot of expectations from Patients, from Medical Practice, Staff and Caregivers. Some of these expectations are; - Appointment Reminder from practice. - Proactive notification for test results. - Clinical reminders for Risk Management including tests/referrals/blood work or therapy. - Reminders for Annual Well Visits. - Prompt call back for left messages. - Timely completion of referral/authorization completed for medications/diagnostic tests. - Call back from providers’ for seeking answers to their health related questions. So accountability in patient engagement means assuming responsibility for above expectations from patients. • Assurance. A positive declaration intended to give confidence; a promise or pledge that a patient’s health related problem will be resolved by his/her doctor. It is utmost important for caregivers or providers to keep themselves well educated with diseases, medications, diagnostic tests and resolutions. This part of patient engagement requires “Providers” to be knowledgeable enough to identify and cure health issues for the patients.

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In this post, I would like to highlight how a “Daily Scorecard” can transform any Medical Practice. We all know that in sports, a scorecard is a sheet, or a book in which scores are entered. In business terms scorecard means a statistical record used to measure an achievement or progress towards a particular goal. We have often heard about “Balanced Scorecard” in the corporate world. The balanced scorecard is a strategic planning and management process that is used extensively in business and industry, government, and nonprofit organizations worldwide to align business activities to the vision and strategy of the organization, improve internal and external communications, and monitor organizational performance against strategic goals. Taking the concept of a scorecard and introducing it in Medical Practice under “Daily Scorecard” can bind all the team members of a practice into one common string. Let’s look at some of the possible daily scorecard items for a practice. • Daily Number of appointments scheduled and seen. This provides a complete analysis of NO SHOW ratio. So if a provider complains that he/she was very slow, the scheduling team knows what to do. It also helps in forward thinking for practice’s workflow planning. • Daily number of patients’ who paid their outstanding balances from the total, who have some kind of balance towards co-insurance/deductible or non-covered charges. This provides an indirect audit on the financial counselor within a practice or front desk team member. No one likes to have bad looking numbers on the scorecard, so it brings a sense of accountability among the team members to outperform day-by-day. • Daily number of patients’ scheduled and eligibility checked. Affordable Care Act has created thousands of insurance patients’ in the past several years; it has also given a way to increased patients’ responsibility. Eligibility Verification is such a crucial part in workflow planning for Medical Practices. This scorecard serves as a quick tally between patients’ scheduled and eligibility checked. Any performance less than 100% shouldn’t be acceptable unless a known factor exists. A known factor could be patients' who have been seen regularly in practice for their risk management. • Daily number of patients’ seen by providers with ratio of number-of-patients to work-hours. It is often observed that patient flow is a big problem in a busy practice. Patient wait time is a big topic for discussion in workflow planning and patient satisfaction survey. We have seen an increased number of technology initiatives to calculate patients’ wait time in reception, exam room, triage and face-to-face time with physicians. A simple scorecard can provide an accurate insight into providers’ performance and keep them focused on their core objective. • Daily number of claims billed. It is necessary to have insurance claims billed out in timely manner. This scorecard can provide

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“Management” is a process of dealing with or controlling things, processes, technology or people. Just like any other business, we find success and failure stories in Medical Practice Management as well. While working with several practices nationwide, I come across practices that are well recognized, well recommended and doing very well financially. In a nutshell, we come across practices that have mastered processes, technology and people management. I call these practices “3R” or well recognized, well recommended, and financially stable institutions. Let’s analyze the reasons behind the success of “3R” practices. Uniformly, these practices adopted what I call, a “Corporate Culture”. “Corporate culture refers to the shared values, attitudes, standards, and beliefs that characterize members of an organization and define its nature. Corporate culture is rooted in organization's goals, strategies, structure, and approaches to labor, customers, investors, and the greater community”. I would like to describe some of these attributes and their relationship to “3R” (Recognition, Recommendation and Revenue). Practice has a Mission Statement. What's a mission statement anyway? A practice's mission statement should represent core values and ideals of the founder’s vision for their practice. It should be a constant reminder to the practice's employees and clients (your patients) of why the practice exists. Furthermore, a good mission statement is the tool by which the practice navigates, and by which patient-centric decisions should be made and measured. This results into recognition, recommendation and financial stability as the practice is driven by a common goal or objective. Here is an example of a mission statement “It is our Mission and Our Pride to provide excellent quality primary healthcare to every individual, regardless of differences in cultural background or language”. It is necessary to keep in mind a practice’s ultimate objective while defining the mission statement. These objectives could govern internal and external factors and can clearly define an actionable plan. A well-defined mission statement leads to establishing core values. The core values are basic elements of how we go about our work. Let’s look at some of these elements. A practice has a defined language and customs for interaction with their patients. Standardization in language, customers and interactions lead towards consistent patient experiences. It creates such a positive and motivational environment for patients. They feel well respected and enjoy coming back to his/her doctor. This can be a possible referral business as a happy customer will bring good referrals. A practice systematically records, analyzes and shares patient feedback internally. Patient survey or feedback results into an indirect evaluation whether our processes/people are working as per the core values. It is an invaluable tool for self-learning and improvement.

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When it Pays to Sweat the Small Stuff How loading the dishwasher relates to clinic optimization Anyone who’s ever reorganized a dishwasher understands the importance of optimization. You know that the dirty side of plates should face the middle. Utensils that are too tall to fit in the carriage on the bottom rack can be laid on their side in the top rack. If you’re just slightly obsessive, like me, you might place all the forks in one compartment, all knives in another, and so on to ensure that unloading will be a breeze. It can be a very simple and enjoyable process depending on how you prep. Even though the technology does the dirty work (pun intended), a human touch is still needed at certain points in the process. What does loading the dishwasher perfectly have to do with your healthcare practice? Well, for starters, the details that staff members may treat as trivial can actually have a major impact on your bottom line. Details like what language to use when talking with patients over the phone or which process to employ when verifying insurance eligibility. You can imagine how a conversation or even tone of voice can affect a patient’s satisfaction levels and willingness to return to the clinic. By the same token, providers want to confirm they’ll get paid for their services before actually providing them. Both scenarios can greatly impact the practice’s profit margin. This is why every single step of your practice’s workflow can and should be examined, no matter how small. Especially in this era of change in healthcare where more technology (EHRs, patient portals, etc.) is in place, payment models are starting to shift (PFS to PFP), and providers are faced with penalties for not keeping up with the pace, clinics nationwide would be smart to start optimizing every nook and cranny of their dishwashers, so to speak. Let’s take the verification of insurance eligibility example. A lot of EHR vendors will proudly tell you that you can check procedure eligibility and copay in real-time through their technology. But what happens if there’s an error? Do you have a workflow in place to regularly check for mistakes and to quickly resolve them? That’s where ClinicSpectrum’s Hybrid Workflow comes in. We have built our business on optimizing many of the workflows that are peripheral to technology. So, in instances where technology does the major lifting, but at some point falls short, we have engineered several tried-and-true processes for clinics to keep operating at maximum efficiency. Our human element wraps around any existing EHR/PM and works as a perfect virtual back-up to technology and existing team members. No joke, we have analyzed all the touch points of EHRs, defined workflows that will not only make your job easier, but also your business stronger. We’re talking about everything from prepping charts, to sending clinical reminders, inquiring about claims and handling recalls.

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Credentialing Dashboards Keep Staffs on Task, Better Communicate Status Dashboards. To some, the concept is met with open minds and eagerness to view the data in a snapshot. To others, the term conjures up a notion of marketing spin. Can anything really be that great? The answer is yes. If done well, dashboards can not only brilliantly communicate key data to your staff, but keep everyone on task and efficient. When looking at physician credentialing, communications are a vital part of the process, as everyone needs to know the status of tasks—what's in progress and what remains to be completed. This information needs to be shared among various stakeholders, such as the credentialing staff, providers, practice administrators, and others. For credentialing, communicating this information is vital to practice operations, reducing risk, and ensuring that providers are eligible to receive reimbursement for their work. Using a credentialing software solution with a dashboard display is an ideal way to share this information in a format that is easily digestible so information becomes actionable. Dashboards are a graphic representation displaying an up-to-date snapshot of tasks, whether they're newly assigned, in progress, on hold, or past due. A credentialing system dashboard should be easily accessed, and provide an overview snapshot, milestones, drill-down capabilities, and the ability to view tasks and processes from different perspectives. Here’s a look at the first two of these. Easily Accessed —When users open the credentialing system, the first thing they should see is the dashboard display. This quickly communicates the status of tasks, and alerts them to issues that need resolving. The easy accessibility of the dashboard eliminates the need for users to click through menus to view the information. It also decreases the chances that important information will get ignored, overlooked or simply not communicated. Overview Snapshot —The dashboard should display a broad overview of the process that users can click on to get more detail, also known as "drill-down" capabilities, which are explained below. This overview enables the dashboard to display information of value to multiple user types, whether they are providers, practice administrators, or the credentialing staff. The dashboard should display: • Status of providers being credentialed (e.g., new, in process, on hold, completed, or custom credentialing) • Counts of providers with insurance • Status of the credentialing process by task • Credentialing task aging (e.g., 0-30 days, etc.) Start by looking for these items in your dashboard, and watch your credentialing process go more smoothly.

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