Six Best Practices for Establishing a Centralized Verification Office: The Experience of Our Lady Health System
November 27, 2017
The Franciscan Missionaries of Our Lady Health System is a five-hospital system in Louisiana with five employed medical groups and a clinically integrated network. Until 2016, each hospital had its own medical staff office handling credentialing for providers, from hospital privileges to payer credentialing. Providers practicing at more than one hospital were separately credentialed at each facility using paper documents. There was duplication across the hospitals, with each managing their processes a bit differently, and nearly a third of the providers required some type of duplicate credentialing. Executive leaders for the system tapped Renee Zimmerman, at the time Director of Medical Staff Services for Our Lady of the Lake Regional Medical Center, to lead the effort to centralize credentialing across the system. Zimmerman took on the project and ten months later the CVO was operational. In a recent interview, Zimmerman, now senior director of medical staff services for the organization, shared the essentials she followed to succeed with the effort.
- Engage key stakeholders, including those closest to the problem.
First, Renee believed leadership buy-in is essential. “I would not recommend moving forward without leadership’s total commitment.” She also made an early decision to hold monthly calls with the chief medical officer at each of the five hospitals and to stay in touch with the leaders of each medical group. Engaging these stakeholders was a key to the successful rollout of the CVO. “The medical group leaders were very pleased with the idea of a CVO and were glad to be involved in the process early,” she observed. For the core work, each hospital provided one to two representatives from its medical staff office. The medical staff offices at each hospital had historically been responsible for all credentialing. Establishing a CVO meant they would need to give up some control of the credentialing process, so their active involvement in determining the future model was crucial.
- Communicate with various constituencies candidly and frequently.
A communication plan was essential. Introducing the new CVO concept, Zimmerman highlighted the benefits providers would see with the new centralized system. A physician only needed to complete a single application, even with privileges at more than one hospital in the system. A single department would mean fewer interactions at one centralized location, with one phone number and one email address. This was communicated early and often. Zimmerman explained that credentialing had evolved and that best practices had emerged that could save time and eliminate some steps from the work flow.
- Maintaining momentum occasionally requires a steamroller.
“The project leader needs to be unafraid to push the process forward without getting hung up on the small things,” stated Zimmerman. “I would say you need someone willing to be a bit of a steamroller to maintain momentum,” she says with a smile. She believes the leader must not shy away from letting everyone know the mission must be accomplished without undue delay. At a three-day session described by Zimmerman as “the granddaddy of them all,” the group faced their toughest decisions. “The most controversy centered on standardizing the process for credentialing a provider. Everyone did it a little differently and had been doing it their way for a very long time.” These individual preferences drove a lively discussion, but Zimmerman stayed focused on the need to standardize. She described two big wins from the meeting that shaved off a huge amount of credentialing time.
- Engage impartial experts to facilitate decision-making.
Zimmerman said it was essential to have best practice experts on board for the duration of the effort. Describing the challenges they faced, Zimmerman recalled, “Our processes had become so painful at such a high level. I knew we would need to turn to experts to guide us through best practices.”
- Rely on a data guru familiar with software and systems.
Data standardization was another daunting challenge. “We needed to standardize every field. Without this standardization, it would have been impossible to pull reliable reports. It took three full days to review and agree on everything,” said Zimmerman.
- Continue gathering and responding to feedback.
Feedback has been overwhelmingly positive. Practice leaders value time savings and the revenue generated by faster payer enrollment. With a new paperless system, Morrisey’s MSOW v. 3, physicians now enjoy the convenience of reviewing their applications from home. On the other hand, changing the reappointment schedule to improve efficiency was a source of frustration for some providers. To mitigate dissatisfaction, Zimmerman communicated often to those who would receive their reappointment applications close to their previous reappointments.
This post is taken from the Fall 2017 HealthStream Provider Advisor. Download the full issue here.