The current onboarding methods are often clunky, time-consuming, and expensive, leading to frustration among new clinicians and, at times, delaying patient care.
Attracting, engaging, and keeping clinicians on board has long troubled healthcare organizations. The COVID-19 pandemic intensified these staffing challenges, which are likely to persist well into the future. Implementing an efficient, streamlined onboarding process that fosters a positive experience for new employees is a crucial step toward improvement. Yet, the current onboarding methods are often clunky, time-consuming, and expensive, leading to frustration among new clinicians and, at times, delaying patient care.
In this article we discuss how adopting a clear, automated, and fluid approach to onboarding can empower hospitals and health systems to smooth the path for new staff and position an organization as a leader in the healthcare sector by showcasing how technology can drive significant improvements.
The Role of Clinician Onboarding in Healthcare Workforce Issues
Clinician onboarding plays a vital role in addressing the complex challenges faced by healthcare workforce management. Integrating new clinicians into the system is crucial, especially now as healthcare teams grapple with high turnover rates, clinician burnout, an aging workforce, and the ongoing impacts of the COVID-19 pandemic.
The 2023 NSI National Health Care Retention & RN Staffing Report, a pivotal reference for nursing turnover, retention strategies, vacancy rates, and staffing trends, reveals that the national nursing turnover rate is nearly 23%, with a vacancy rate for registered nurses around 16%. These shifts in the workforce are alarming, not only due to their impact on patient care but also because of the significant financial strain they impose.
The report further estimates that the cost of losing a single nurse has climbed to $52,350—a 14% increase from the previous year. This translates into an average loss of $6.6 million to $10.5 million per hospital annually. Moreover, a major factor driving these costs is physician burnout, which often stems from a poor work environment, overwhelming administrative duties, and inefficient systems that complicate rather than facilitate patient care.
These issues collectively highlight the critical need for better clinician retention strategies. Enhancing the clinician's journey from day one by equipping them with effective tools and support is imperative to reverse these troubling trends. This approach not only aids in retaining talent but also ensures that clinicians can provide the best patient care without undue stress or hindrance.
The Challenges in the Current Onboarding Process
While onboarding is recognized as a crucial step in integrating new clinicians into healthcare systems, many hospitals still struggle without a cohesive solution to manage the process efficiently. New employees often find themselves navigating a labyrinth of systems and procedures involving credentialing, privileging, and enrollment. This complexity not only frustrates new hires but also burdens organizations with unnecessary costs.
The financial impact of an inefficient onboarding process is staggering, potentially costing up to $300,000 per clinician. More importantly, it diverts time away from patient care. Clinicians may need to resubmit documents or reiterate their license numbers up to 30 times, and that's just the beginning—this doesn't cover learning hospital policies, procedures, or the nuances of scheduling and billing. When onboarding relies on manual processes, where every step must be flawlessly executed before moving to the next, a single hiccup can stall the entire operation.
The tasks of provider credentialing and payer enrollment exemplify the complexities of healthcare onboarding. These essential steps can take anywhere from 90 to 180 days from the initial application to final verification and approval, varying widely across states and organizations. Each payer network brings its own set of rules and required documentation, compounding the amount of paperwork and increasing the likelihood of errors. This variability and the depth of the documentation required can significantly delay the time it takes for clinicians to start providing care, underscoring the need for a more streamlined and efficient onboarding approach.
The Role of Credentialing in Provider Onboarding
Credentialing plays a crucial role in the onboarding process of healthcare providers, serving as a safeguard to ensure that only qualified physicians are admitted to hospitals, private medical practices, and other healthcare facilities. This critical safety check verifies that doctors possess the necessary education, training, and licensure to provide patient care.
The credentialing process involves multiple stakeholders, including healthcare providers, health plans, healthcare facilities, and credentialing verification organizations, and is known for its complexity. With several steps and ample room for errors, credentialing can sometimes extend over months, leading to frustration for all parties involved.
Credentialing Application Essentials
The credentialing journey begins with the application, where providers detail their qualifications, including education, training, certifications, experience, and licensure, along with any past disciplinary actions or suspensions. This self-reporting step is pivotal but can be intricate and time-consuming. It’s crucial that the application is meticulously filled out; any incomplete or inaccurate information is a common pitfall that leads to delays in the credentialing process.
Initial Review and Verification
Following submission, each application undergoes a thorough review to ensure it is complete, encompassing critical details such as the practitioner’s education, training, licensure, and work history. If anything is missing, the application is returned to the provider for completion. This stage acts as a gatekeeping phase, ensuring all necessary information is confirmed before allowing a provider to offer care, upholding the high standards of patient safety.
Engaging Providers for Missing Information
Should the application be incomplete, the credentialing process encounters its first major obstacle. It’s essential to promptly engage with providers to gather the missing pieces. Outreach efforts might include automated notifications, emails, faxes, or direct calls from credentialing professionals. Challenges such as incorrect contact information can cause further delays, as credentialing teams struggle to connect with providers to correct inaccuracies.
Primary Source Verifications
After the application is finalized, it moves into the phase of primary source verifications (PSVs). This detailed verification phase can be time-consuming as it involves contacting and confirming the authenticity of every piece of information from various sources such as educational institutions, licensing bodies, professional associations, and previous employers.
Monitoring for Sanctions
The ability of a healthcare provider to offer services can be significantly impacted by sanctions imposed by regulatory bodies like the Office of the Inspector General (OIG), the System for Award Management (SAM), the Centers for Medicare and Medicaid Services (CMS), and various state licensing boards. These authorities can enforce sanctions for violations including malpractice and civil judgments, which can seriously affect a provider's standing and their compliance with state and federal regulations, potentially leading to substantial fines, loss of license, operational disruptions, and damage to reputation.
To mitigate these risks, it is crucial for healthcare organizations to implement robust, continuous sanctions monitoring. This ensures all network providers maintain good standing by regularly verifying their status with regulatory bodies and keeping licenses and other credentials current.
Management of Expirables
Credentialing initially captures a momentary snapshot of a provider’s qualifications. Known as "expirables," these credentials like licenses and certifications have an expiration date and must be periodically renewed for the provider to legally continue their practice. This makes it vital for providers to keep their credentials current and inform the credentialing organizations of any changes.
Credentialing Verification Organizations (CVOs), along with health plans and other related entities, routinely monitor various databases to ensure that all network providers hold valid and active licenses, malpractice coverage, and other necessary documents to maintain compliance and ensure patient safety.
Recredentialing
Healthcare delivery is dynamic, necessitating regular recredentialing of providers—typically every two to three years, though some require it more frequently. This process involves providers updating their information regarding credentials, licensure, and training. Healthcare organizations, plans, or CVOs then revalidate this information against primary sources. Efficient management of this process is essential, as failure to update public directories with current insurance information of providers can lead to significant liabilities under regulations such as the No Surprises Act of 2022, which demands timely and accurate insurance enrollment information.
Challenges in Healthcare Provider Credentialing
Navigating the healthcare provider credentialing process presents a variety of hurdles that can complicate or delay successful completion. The process starts with data challenges, where incomplete or absent information can stall applications even before they reach the primary source verification stage. Credentialing teams must then engage with providers to fill in these gaps, a process that can extend the timeline by days or even weeks depending on how quickly providers respond.
The situation is further complicated when the information provided is outdated or incorrect. Inaccuracies in critical details like certification, licensure, or contact information add layers of complexity for credentialing teams as they struggle to secure accurate verifications swiftly.
Another significant hurdle arises towards the end of the credentialing process during the convening of credentialing committees. These committees are essential as they review and approve applications before providers can begin offering services. However, organizing these committee meetings can be fraught with administrative delays, often complicated by the challenge of coordinating the schedules of busy healthcare professionals to review large volumes of applications.
Moreover, the sheer volume of applications can exacerbate these challenges, especially as health plans expand into new markets, requiring the credentialing of hundreds or even thousands of providers simultaneously. This scale can stress existing processes, stretching the capacity of credentialing teams and systems.
Finally, external factors such as changing regulations, evolving standards from industry groups, or state government mandates can force healthcare organizations to continuously adapt their credentialing workflows and verification scopes. This dynamic environment requires organizations to be agile and responsive to ensure compliance and maintain the pace of credentialing necessary to meet operational demands.
The Role of Technology in Onboarding Complexities
Technology has become a critical ally in streamlining the complex onboarding processes in healthcare. Intelligent automation, for instance, bridges the gaps between various disconnected systems, creating a more cohesive and efficient experience both for the clinician and the organization.
Traditionally, provider credentialing has relied on teams performing meticulous, labor-intensive tasks repetitively and flawlessly. They must ensure applications are complete and compliant, then reach out to various entities to verify information—often having to make multiple contacts when responses lag. This exhaustive process repeats thousands of times across credentialing bodies, networks, and health systems each year.
It's no surprise that organizations are seeking more effective solutions. There are numerous avenues for health plans and other entities responsible for credentialing providers to improve efficiencies, including:
Automating Healthcare Provider Credentialing Applications
Automation transforms the repetitive, structured tasks inherent in practitioner credentialing. Manual processing not only introduces a high potential for human error but also incurs significant costs and time delays. Medical practices, on average, spend around $7,000 and 20 administrative hours on each credential application. Misentries like incorrect phone numbers or email addresses by administrative staff can cause significant delays in provider approvals, leaving them on the sidelines for months and impacting both the financial health of practices and patient care access.
Automating Primary Source Verifications
Automating the verification of primary sources marks a revolutionary shift in streamlining the credentialing process. Traditionally, this phase involves tedious manual checks where professionals contact educational institutions, previous employers, and licensing boards to confirm the veracity of submitted information.
Improving Credentialing Committee Operations
Enhancing the operations of credentialing committees also plays a pivotal role in refining the overall process. The goal here is to streamline the evaluation phase to focus solely on either approving or denying healthcare providers' applications to join provider networks. By classifying providers into groups based on the cleanliness of their files and potential red flags such as sanctions or alerts from the National Practitioner Data Bank (NPDB), committees can expedite approvals for compliant providers while dedicating more time to scrutinize those with flagged issues. This method ensures that only the most qualified providers gain network privileges, enhancing both efficiency and decision quality.
Credentialing Verification Organizations (CVOs)
Credentialing Verification Organizations (CVOs) offer another layer of specialization in this ecosystem. These independent bodies focus solely on the credentialing process, leveraging advanced software and comprehensive data infrastructure to perform verifications more efficiently than in-house teams. By outsourcing to CVOs, healthcare organizations can significantly reduce their administrative load, ensuring a faster and more accurate verification process. CVOs excel in detecting any discrepancies or red flags in a provider’s credentials, such as unverified educational backgrounds or inconsistencies in work history, which safeguards the integrity of the network and improves patient care outcomes by allowing only the most qualified providers to participate.
Streamlining Healthcare Provider Onboarding
Traditional provider credentialing methods typically involve a team performing meticulous tasks repeatedly, a process that can be both time-consuming and prone to errors. Streamlining clinician onboarding with transparent, efficient self-service options not only saves healthcare organizations significant amounts of money per clinician but also speeds up the cycle of onboarding. This quicker integration into the system allows clinicians to start providing patient care sooner and reduces turnover, enhancing the overall provider experience.
An effective and welcoming onboarding process increases employee satisfaction, bolstering the reputation of hospitals as desirable workplaces and making it easier to attract and retain essential medical talent.
Credsy's credentialing software revolutionizes this approach by providing a seamless, efficient solution that significantly cuts down provider licensing times. Our platform streamlines the entire credentialing process, eliminates cumbersome paperwork, and secures data in a cloud-based system. We offer personalized support through a dedicated 24/7 account manager ready to assist with any queries. Moreover, Credsy doesn't just simplify the credentialing tasks; it also enhances Revenue Cycle Management (RCM), reducing denials and boosting revenue potential. Our comprehensive services, backed by years of industry expertise, ensure full compliance with all relevant regulations, making operations smoother and more efficient for healthcare practices.