Recredentialing? It's a two-minute job

This doctor's simple system makes quick work of a burdensome chore.

By Lucy E. Hornstein, MD
Family Physician/Valley Forge, PA

Does the mere thought of recredentialing fill you with dread as you anticipate fishing through piles of paper to supply insurers with copies of your medical license, DEA certificate, proof of malpractice coverage, and so on? Not me. I can complete a recredentialing packet and have it off my desk in about two minutes. Here's my method:

Whenever I receive a new medical license or DEA certificate to replace an expired one, I make a half-dozen copies immediately and file them together. I do the same thing in December when my new malpractice policy comes. My board certificate? I copied it before I sent it to be framed, and keep a sticky note on the last copy in the file so I don't inadvertently send that one out.

I also keep copies of the latest letter from my hospital stating that I'm an active staff member. But that's seldom needed; many insurers now just want you to sign a release so they can verify your status directly with the hospital.

Open malpractice claims? I happen to have one pending. Even though each insurer has different forms, they all want the same information. So I typed a brief review—including relevant dates and medical details—made a few copies, and filed them. On the insurers' forms, I write "see attached." No one has ever complained.

Your personal and practice information, like addresses and phone numbers, is already on file with the insurer, so you just have to give your profile a once-over and note any changes. If anyone asks, I also keep a few copies of my CV.

Next, I run down the list of questions about whether I've been disciplined, had privileges revoked or limited, used drugs, or been convicted of a felony—thank heaven they don't care about the citation for an expired inspection sticker on my van—then sign and date it. Using their checklist, I tick off the papers they want as I pull them out of the file. I even present them in the order requested since I try to keep my file in the same sequence.

Stuff the whole thing into their envelope and, presto, it's done. I usually note the date on the checklist page and keep it with other contract information so if an insurer misplaces my recredentialing package, I can tell them the date I mailed it.

And there you have it: recredentialing in no time flat!

More tips on streamlining the recredentialing process

The author's system works well. Here are comments from a number of practice management consultants that can make it work even better:

• Have your office manager copy and compile documents. You need only update legal problems and attach summaries of malpractice suits. — Judy Bee, www.ppgconsulting.com .

• Be sure that copies of medical licenses and DEA certificates are kept in a secure spot so they don't fall into the wrong hands. — David C. Scroggins, Clayton L. Scroggins Associates, Cincinnati.

• Send the recredentialing package certified mail, return receipt requested. — Gray Tuttle Jr., Rehmann Robson/PCI, Lansing, MI.

• Make—or have your staff make—a follow-up phone call to ensure that the managed care organization correctly processed the paperwork. — Michael J. Wiley, Berdon Healthcare Consulting, Jericho, NY.

 

Lucy Hornstein. Recredentialing? It's a two-minute job. Medical Economics 2002;5:62.