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The Impact of COVID-19 on Healthcare Credentialing and Licensure

The medical profession is justifiably known for rising to a crisis, and the response to COVID-19 is no different. Every day, tireless professionals on the front lines are providing outstanding patient care while creating on-the-spot workarounds for equipment shortages and other issues.

That same can-do spirit is also fully present in the profession’s support teams, who are streamlining processes and reinventing systems in order to deploy caregivers as quickly as possible to where they are most needed. One result is that the credentialing and licensure process looks very different now than it did just a few weeks ago, says Vicki Searcy, Vice President, Consulting Services, at VerityStream.

“One of the greatest challenges now is making sure that you have the right physicians and other healthcare professionals ready to deal with the care that’s needed,” Searcy says. “If you are a health system, that may involve putting procedures in place for moving people around within your system. If you are a freestanding hospital, you may need to provide emergency privileges to care providers who have not been part of your healthcare organization in the past.”

“In the face of this pandemic, it’s pretty clear that everyone’s facing a workforce challenge,” continues Todd Sagin, President and National Medical Director, Sagin HealthCare Consulting. “And not just privileged practitioners, but all kinds of healthcare clinicians and non-clinicians are in short supply in certain localities. We’re worried in particular about privileged practitioners in some key areas: hospitalists, for example, intensivists, pulmonologists who can help manage ventilators and respiratory therapists. These are some of the areas where it is anticipated that the needs will be most acute, and there are pools of retired practitioners and part time practitioners, who are not necessarily doing today what they have done in the past, that can be accessed to try and bolster the workforce.”

Onboarding these practitioners as rapidly as possible is a heavy lift, but it has been made somewhat easier by the ground-breaking changes that have come as result of the National Emergency declaration on March 13:

  • Certain requirements with regards to background checks and other kinds of requirements to vet providers to enroll them in Medicare are waived. There are two types of these “blanket” waivers:
  • Provider Locations. CMS has waived requirements that out-of-state providers be licensed in the state where they are providing services when they are licensed in another state.
  • Enrollment in Medicare. CMS is allowing new, non-certified Part B suppliers, physicians, and non-physician providers to expeditiously obtain temporary Medicare billing privileges. CMS is also waiving certain application fees, criminal background checks, and site visits with respect to provider enrollment.

This blog post is the first in a series of excerpts from the VerityStream article, “An Upside Down World: Pandemic Creates Process Challenges and Opportunities for Licensure and Credentialing.” The article also covers:

  • Telehealth plays prominent role in new reality
  • Keeping processes effective, but uncomplicated, will be essential
  • Today’s adaptations and new procedures are likely tomorrow’s business as usual
  • Patient outcomes should drive “in the moment” decision-making

PLEASE NOTE: The information in the article excerpted here was considered current at the time of its publishing, 7/30/20. However, the COVID-19 pandemic is an ever-evolving disaster due to new findings, data, and availability of resources. Please refer to the CDC website for the latest detailed information when you need it.

In the midst of continual healthcare change some things stay the same, like the need for comprehensive provider credentialing, privileging, and enrollment processes. In today’s value-based environment, operational efficiency is critical. Conducting manual verifications, completing paper forms by hand or taking time to deliver files to various locations across the hospital or the system is not cost-effective. Learn more about making VerityStream your comprehensive provider solutions partner.


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