In the past year, healthcare organizations have faced a variety of challenges in the face of COVID-19, one of them being a clear need to streamline credentialing processes to provide the safest care possible to patients. The Centers for Medicare & Medicaid Services (CMS) requires that hospital-based physicians are credentialed, although physicians providing care in private physicians’ office are not held to the same requirements. The credentialing process in healthcare has become increasingly complex with the expansion of providers’ roles, third-party tax payer requirements and organizational standards. RLDatix’s Applied Safety Intelligence™ framework makes a connection between patient safety and risk management, focusing on moving the industry from a reactive, retrospective review of adverse events toward proactive prevention, which includes compliance and provider management as key components.
Leveraging a Robust Credentialing Process to Reduce Risk, Support Safety
Without a robust credentialing process in place, healthcare organizations put the safety of patients at risk and expose their organizations to legal ramifications that could jeopardize their reputation and result in costly fines. In a recent case in North Carolina, The Division of Health Benefits failed to both identify and remove providers whose professional licenses have been suspended or terminated, resulting in millions of dollars inappropriately distributed to unlicensed providers.
RLDatix’s Provider Management solution provides a turnkey credentialing, privileging and performance monitoring solution to ensure safe, high-quality patient care. Equipped with streamlined workflows, organizations are set up for success to pair software with services and eliminate administrative burdens, creating an efficient process. The system also helps organizations manage and maintain comprehensive up-to-date profiles for providers and other clinicians.
An effective provider management tool should also have capabilities that support ease of use for providers and clinicians. The RLDatix platform delivers time-saving workflows, optimizing credentialing leadership and committee effectiveness and increases provider satisfaction with a mobile profile to update personal information and maintain documentation.
Going Above and Beyond: Opportunity for In-Depth Credentialing Services
Across healthcare, there is a need for more in-depth credentialing efforts. Healthcare organizations can go beyond what is required by the National Committee for Quality Assurance (NCQA) which does not require expiring records management, but rather sanctions monitoring and implements a full refresh on licensure and certifications every three years. Many changes can occur in that time period which makes an increased level of real-time credentialing management essential. An in-depth credentialing tool such as RLDatix’s Provider Management solution centrally maintains provider records, enabling organizations to lessen risk and improve patient safety by ensuring that providers are equipped with necessary credentials to properly care for patients.
Adopting an Integrated Approach to Provider Credentialing
In light of the pandemic and the increased need for physicians to care for COVID-19 patients, it’s never been more important for healthcare organizations to have robust credentialing processes and systems in place. Credentialing is a key component of an effective patient safety strategy. Without a credentialing system in place, healthcare organizations risk losing valuable time, money and resources. RLDatix’s integrated approach to credentialing supports healthcare organizations’ HRO initiatives by streamlining workflows, enabling data connectivity and breaking down silos.
To learn more about how RLDatix’s Provider Management solution can support your credentialing and privileging efforts, click here.
