Issue link: https://beckershealthcare.uberflip.com/i/1546114
16 EXECUTIVE BRIEFING 1 EXECUTIVE BRIEFING T he shift away from inpatient care to care in ambulatory surgery centers (ASCs) continues to accelerate. To maintain a lower-cost site of care setting, ASC leaders now must focus on revenue recognition and optimizing labor, supplies, anesthesia and payer contract issues. When it comes to operational efficiency, ASCs often overlook the importance of provider credentialing and payer enrollment. If new physicians are onboarded slower than expected, surgeries may need to be cancelled. As a result, revenue is lost from day one, negatively impacting the bottom line. Rather than attempting to handle credentialing in- house, many ASCs have decided to turn to strategic partners. To learn more about the benefits of partnering for credentialing, Becker's Healthcare recently spoke with Claire Forgan, General Manager, Credentialing Cervices and Rachel Woodhouse, Director of Extended Credentialing Services at Modio Health. Credentialing implications for ASCs Credentialing impacts clinician satisfaction and ASC's financial performance. This impact starts with the onboarding process and the collection of provider information. The goal is a smooth onboarding process so provider enrollment is complete before surgeries are scheduled. The next step is verifying provider information. The faster this happens, the faster physicians see patients and start generating revenue. Unfortunately, verification processes can be difficult. If provider documentation isn't clear and thoughtfully presented, it becomes a pain point for the ASC medical director or credentialing committee. However, credentialing doesn't stop with onboarding. Ongoing monitoring of licenses and malpractice insurance is also essential. Without that in place, ASCs can encounter compliance issues. Given the complexities of provider credentialing and enrollment, hospitals and health systems typically have a department dedicated to this work. For most ASCs, that's not feasible. "At ASCs, there's often one person handling credentialing along with office management, billing and other tasks," Ms. Woodhouse said. "Yet, the provider complexity can be even greater, since physicians often enroll with several ASCs and move around. It's tricky to manage that with a small staff." Why outsourcing matters To decide whether to outsource credentialing or keep it in house, ASC leaders must analyze their current state of credentialing. Based on her experience, Ms. Forgan identified several red flags that indicate when outsourcing can help organizations. The first is high staff turnover or a lack of adequate in- house credentialing expertise. "No one really notices credentialing until something goes wrong," Ms. Woodhouse said. "Then ASCs find themselves in a bind. Outsourcing can prevent panic." Another indicator is in-house teams with poor credentialing performance. Key metrics include low approval rates and slow turnaround times. These issues can be roadblocks to rapid growth. "When ASCs grow quickly, they need to credential providers faster. That can be very difficult without a big team," Ms. Forgan said. A third indicator is inconsistent demand for credentialing. If the need for credentialing is low some months but spikes in others, an outsourced partner helps manage the ebb and flow. This also frees up ASC employees, enabling them to focus on other projects. How strategic provider credentialing partnerships help ASCs scale efficiently