I once heard a great talk by Dr. Dike Drummond on the epidemic of provider burnout, and he used the term “dilemma” as a problem that never goes away. There is no one-step solution for it. It needs a strategy of multiple steps to reach an acceptable outcome. Now that is a broad summarization from his presentation, but it applies perfectly to the Anesthesia Credentialing Process.
The term “credentialing” encompasses two phases: credentialing and privileging. Credentialing entails verification of the anesthesia providers history such as education, training, licensure, malpractice and other information to ensure they are eligible for privileging. Privileging grants the anesthesia provider authorization to work within a specific scope of practice based on their qualifications.
Ask any anesthesia provider about the credentialing process they went through and you will hear the same answers over and over. It was a pain. It took forever. Why can’t it be easier? Even the credentialing specialist for the facility will express the frustration with the length and the amount of effort taken to ensure all the required documentation is complete. The whole process can take between 60 to 120 days!
Now credentialing is never going away. It is legally required to ensure a provider is qualified to work and administer anesthesia to the facility’s patients. Credentialing is also needed to meet the professional and accreditation requirements of organizations such the Joint Commission (TJC), the National Committee for Quality Assurance (NCQA), and The Centers for Medicare and Medicaid Services (CMS).
So what can be done for this dilemma that is never going away? Well, understanding the process and common bottlenecks can help expedite and relieve some of the frustration with credentialing.
“Houston we have a problem”
The credentialing specialist’s role is to collect your information that is required to meet the facility’s credentialing policy. This is where the biggest hold up appears according to anesthesia credentialing specialists. Incomplete information, explanations of gap history and malpractice issues are time consuming and can stretch into days or weeks of back and forth communications. Common missing information that delays the first part of the process include:
- Peer references – choose reliable people
- Certificate of Insurance (COI) – contact your current or former group for this information
- Pending state medical license – check in with medical board for update of approval
By creating a packet with all the required information ahead of time you can help reduce the headaches and delays that can prevent you from starting.
Time For Signatures
Once all your information is collected and has been verified then the privileging process can start. Your credentialing packet can end up circulating between multiple people and committees which is all dependent on the facility’s bylaws. They review your packet to make sure you are qualified to provide anesthesia care for the patients. Sometimes they have questions or require further explanation of issues from you before signing approval of anesthesia privileges.
Unfortunately, some of these committees meet only once a month. So if your credentialing packet is completed the day after they meet you will be waiting another month before receiving privileges. Just another reason to submit your information completely and as quickly as possible.
A couple last things. Staying in constant contact with your credentialing specialist and replying to requested information right away will help keep the process moving forward. Most likely, you will go through this process again at some point in your anesthesia career. Keep a folder with all your information that was submitted and continually update your CV so you are ready to go next time.