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Data Is Key For Credentialing, Privileging, And Provider Enrollment: Q1 2017 Provider Advisor

When it comes to credentialing, privileging, and provider enrollment, the key to quality and efficiency is consistent, accurate, accessible data. Don’t you wish you had a dollar for every minute you’ve spent in your career tracking down missing or inconsistent provider information? When was the last time you were up at midnight reconciling information across handwritten notes, Excel files, and old hospital records? As managers, can you even begin to estimate the amount of money your organization spends each year in search of clean provider data? In this edition of Provider Advisor, we look at a few organizations who are market leaders in developing solutions to the problem of collecting and maintaining robust data on their providers.

First, we take an in-depth look at the work being done by Christy Treacy and her team at BJC HealthCare. Christy manages the Centralized Verification Office (CVO) and Provider Data Management Center (PDMC) across 15 BJC hospitals and multiple community health locations, tracking data and activities of some 45,000-50,000 active and referring providers. In this article she talks about their journey to create one Master Provider Database that is the single “source of truth” for all of BJC. Christy discusses the important role that data governance has played in their success and the numerous operational benefits that have been realized.

We also take a look at the work that has been done by Michelle Vaughn, Director of Revenue for PhyMed Healthcare Group, a system of more than 600 physicians operating in hospitals, ambulatory surgery centers, and physician offices throughout Pennsylvania, Kentucky, and Tennessee. Due to an inadequate provider enrollment process, PhyMed was experiencing excessive write-offs and poor revenue cycle management. A hesitancy to automate the provider enrollment function and go paperless was limiting overall growth of the company. Over the past two years, PhyMed has achieved full automation of the enrollment process and greatly improved financial results.

Finally, we take a look at patient safety. We learn about some interesting patient safety trends from the unique perspective of an orthopedic trauma surgeon practicing in Ft. Myers, FL, and hear about the impact an automated privileging tool has had ensuring patient safety and improving outcomes at Johns Hopkins.

Articles in this issue include:

  • Executive Letter

    It All Starts with Good Data

  • Feature Article

    A Look at the Healthcare Industry through the Eyes of a Trauma Surgeon: An Interview with Dr. Patrick Leach

  • Feature Article

    PhyMed HealthCare Group’s Provider Enrollment Turnaround

  • Feature Article

    BJC HealthCare: Pushing Provider Data Management to the Next Level

  • Industry Challenge

    Healthcare Contact Centers Mature to “Own” the Patient Experience

  • Under the Microscope

    The Stakes Just Got Higher –How Will Your Practice Respond to the MACRA?

  • Product Innovation

    Combining Privileging and Competency Data to Ensure Patient Safety and Improve Outcomes

  • Get Engaged with Echo–A HealthStream Company
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