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Welcome to the 12th Annual
HealthLine Systems™ Client Strategy Conference
October 24-25, 2001Hyatt Regency
Chicago, IL
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Today’s Objectives• Demonstrate time-savers to help the
“understaffed” office meet objectives with current staff
• Identify new ways to use MSLW/Echo to reduce costs
• Explore changes in technology & regulatory requirements
• Identify & share “best practices”
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The Actions
• Four in-depth, practical sessions
• Three relevant case studies
• Networking opportunities
• Review of the OIG program
• HealthLine Systems’ future plans
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Credentialing Past & Present
• Fundamentals of credentialing remains unchanged from the typewriter & file cabinet days:~ Verify everything~ Verify as quickly as possible~ Grant privileges specific to the providers
education and training
• So what does the future hold?
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The Challenge for MSSP’s
Lack of staff
Background checks
Retention of files Allied Health
Privileges - Core, Temp’s, Lists
Locum Tenens
JCAHO, NCQA, URAC
Technology
HIPAA
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Do More with Less
• Credentialing is a labor & materials intensive process. For example:
• $463.00 to process a new applicant~ Administrative overhead -- $103.00~ Staff time -- $322.00~ Verification costs $38.00
• Staff time & overhead = 90%
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Electronic Credentialing
• More electronic sources now available - over 50 internet sources
• Online applications slowly gaining acceptance
• Scanned copies eliminates paper
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More Requests for Information
• More organizations requesting ‘detailed’ information
• Dissemination of ‘real-time’ clinical privileges
• Internet based ‘auto-verify’• Intranet based R & R’s, bylaws, calendars• Online status checks
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Economies of Scale
• “Standardized” state-wide applications
(4 mandatory, dozens voluntary)• VetPro - the VA data bank• CAQH common database• Centralized credentialing, particularly for
health system with MCO’s
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According to the Crystal Ball
• 2005 - 100% electronic credentialing
• QA data electronically shared
• Federal data sources provide immediate reports
• PDA’s used to view information