Using Seeker in Onboarding Providers

Transcription

1 Using Seeker in Onboarding Providers Muffie Gallardo, CPCS, CPMSM Midas+ Product Manager - Seeker Objectives Understand the Onboarding concept and how credentialing and privileging fit into Onboarding Identify opportunities to Onboard Review tips for implementing Onboarding Learn how Seeker can support Onboarding throughout the Health System Learn how to optimize Onboarding and Seeker to improve efficiency and productivity 2014 Midas+ Symposium May Tucson, AZ 1

2 Onboarding The process of acquiring, accommodating, assimilating, and accelerating new providers into the organization In healthcare, it means streamlining processes in order to eliminate redundancy and frustration on the part of the provider applicant Concurrent processing of a provider through the application process How to Begin Onboarding Departments who will be involved Identify the work requirements to be supported by each department Develop a preliminary work flow that describes access and work effort Determine resource needs to support work flow Create a Project Document - Compare the old versus new process - Denote the key benefits - Outline the project scope, any assumptions, approach, resources, and deliverables - Obtain approval of administration and stakeholders 2014 Midas+ Symposium May Tucson, AZ 2

3 Things to Consider Business relationships between the hospital, the credentialing verification office, provider services, and provider enrollment staff (work with the hospital leadership and legal department if this relationship appears to be complex) State laws regarding sharing of primary source verifications Developing Onboarding Process Establish trust between the departments involved Work together to establish a well-documented process that ensure consistent communication and sharing of information Maintain an excellent line of communication between those involved Determine if HR can use the credentialing application with an employment addendum 2014 Midas+ Symposium May Tucson, AZ 3

4 Seeker Setup for Onboarding Create Organizations for: Physician Recruitment Physician Group Set up users and security Create Online Applications Create necessary Focus Studies Departments Involved Physician Recruitment Medical Staff Services/Credentialing Verification Office (MSS/CVO) Human Resources (HR) (if employed) Provider Enrollment Physician Group 2014 Midas+ Symposium May Tucson, AZ 4

5 Additional Departments Graduate Medical Education (GME) Faculty Departments Health Plans Central Billing Office Initial Steps - Physician Recruiting Enters provider data into Seeker Reviews curriculum vitae and scans into Seeker Confirms provider is qualified for staff membership Defines provider in Online Application Provider Definition or furnishes applicant with the initial application Verifies all state licensures, DEA, board certifications Generates and tracks references in Seeker Performs a background check 2014 Midas+ Symposium May Tucson, AZ 5

6 Initial Steps - Physician Recruiting (continued) Scans all verified items into Seeker Tracks recruiting process in Organization record Uses Focus Study for checklists, references, interviews Provider contract documented in contract grid with signed copy attached Notifies MSO/CVO, Provider Enrollment and HR (if employed) that all pertinent information has been uploaded Concurrent Activities Medical Staff Services/Credentialing Verification Office Reviews data obtained by recruiter Notifies provider of any additional data needed Educates applicant about staff membership application process Processes application, obtains remaining verifications Obtains supporting documentation for privileges Creates an Organization Entry for applicable hospital(s) Processes the application through the Professional Staff leadership approval process Upon Board approval generates Board letters from User Report Processing 2014 Midas+ Symposium May Tucson, AZ 6

7 Human Resources Concurrent Activities (continued) Utilizes background check from recruiting Shares credentialing data with MSS/CVO Shares benefits, and payroll information with Faculty Department Physician Group Delegate credentialing activities to MSS/CVO Delegate enrollment activities to Provider Enrollment Completes any other necessary activities and documents in the provider organization record Concurrent Activities (continued) Provider Enrollment Begins contract and application process for health plans Saves and/or scans payer applications in Contracts grid Documents dates and details in the Contract grids, as appropriate 2014 Midas+ Symposium May Tucson, AZ 7

8 Concurrent Activities (continued) Graduate Medical Education For Residents, begins the credentialing process for the MSS/CVO Obtains medical school verification Tracks rotations, evaluations, monitoring issues, CME activities Faculty Department Track appointment in Professional History Grid or individual Organization record Shares benefits, payroll, etc., data with HR Health Plans Concurrent Activities (continued) Delegate credentialing activities including site visits to MSS/CVO Obtains Medical Staff Directory from User Report Processing 2014 Midas+ Symposium May Tucson, AZ 8

9 Functions in Seeker to Support your Processes and Onboarding Customizable settings Security Automated data entry Online verifications Worklist Attachments Focus Studies Reporting Customizable Settings There are three types of customizable settings to help expedite your data entry and give you control over specific areas of access Default Settings User Specific Settings Organization Specific Settings 2014 Midas+ Symposium May Tucson, AZ 9

10 Default Settings (Function > System Management > System/User Securities > Default Settings) User-specific Settings (Tools > Options) 2014 Midas+ Symposium May Tucson, AZ 10

11 QRXS Default Definition (Function > Compliance > Queries > QRXS/CQ Default Definition) Organization Definition (Function > System Management > System /User Securities > Organization Definition) 2014 Midas+ Symposium May Tucson, AZ 11

12 Organization Definition (continued) Organization Definition (continued) 2014 Midas+ Symposium May Tucson, AZ 12

13 Organization Definition (continued) Tip: Physician recruiter can open Bylaws and Policies and Procedure and send to the applicant. Securities (System Manager Function) Seeker access can be entry or inquiry for any page of data and can be taken down to a grid level Onboarding and sharing of data can be as open or as limited as you desire Organization Security in User Definition can be applied to entry, inquiry or reporting 2014 Midas+ Symposium May Tucson, AZ 13

14 Privacy Profile (Dictionary Maintenance>Privacy Profile (#558)) Define privacy profiles to control which provider fields are blocked from the view of selected users. In particular, privacy profiles control the display of fields in provider lookup, the Provider Header, and provider functions. Privacy Profile (continued) Use the Seeker tab to select which providers to block on the Provider Lookup form. Providers who meet the criteria selected on this tab are blocked from view on the Provider Lookup form To support information sharing and onboarding, you can create a privacy profile for HR to see only employed physicians and Allied Health Professionals We have defined provider Staff Types for Medical Staff Employee and Allied Health Professional Employee 2014 Midas+ Symposium May Tucson, AZ 14

15 Security Examples Physician Recruiter Seeker Access Biographical Entry Organization Entry Selected Reports User Report Processing for ReporTrack reports and documents Online Application Provider Definition Focus Study Organization Security Entry to Physician Recruitment Organization Security Examples Medical Staff/Credentialing Verification Seeker Access Biographical Entry Organization Entry All Reports ReporTrack and/or User Report Processing for ReporTrack reports and documents Online Application Provider Definition and User Review Focus Study Organization Security Entry to their organizations Inquiry access to Physician Recruitment and Health Plan Organizations (if separate) 2014 Midas+ Symposium May Tucson, AZ 15

16 Security Examples Human Resources Seeker Access Biographical Entry or Inquiry Privacy Profile to restrict to employed providers only Organization Security Inquiry to selected data Security Examples Provider Enrollment Seeker Access Biographical Inquiry only Privacy profile to block sensitive data User Report Processing for selected ReporTrack reports and documents Organization Security Entry to the contracts grid on the Contracts/ Monitoring page in Organization Entry 2014 Midas+ Symposium May Tucson, AZ 16

17 Security Examples Physician Group Seeker Access Biographical Inquiry only Privacy profile to block sensitive data Focus Study Organization Security Entry to the physician group organization Security Examples GME Department Seeker Access Biographical Entry or Inquiry GME Entry User Report Processing for selected ReporTrack reports and documents Organization Security Inquiry to hospital organization (optional) 2014 Midas+ Symposium May Tucson, AZ 17

18 Seeker Access Biographical Inquiry only Privacy profile to block sensitive data User Report Processing for selected ReporTrack reports and documents Security Examples Health Plan Organization Security Entry to the health plan organization Inquiry access to hospital organization(s) If using hospital organization record for entry, can provide inquiry only to all but contract grids which will be entry access Security Matrix 2014 Midas+ Symposium May Tucson, AZ 18

19 Automated Data Entry Online Application Batch Edit Document Checklist QRXS OIG Comment Templates Onboarding Uses for Online Applications Physician Recruiter can initiate the pre-application and application process MSS/CVO can initiate the pre-application and application process for providers not coming through the recruiter Provider Relations or MSS/CVO can initiate profile review through online application Provider Relations or MSS/CVO can review and approve physician updates form online application for that purpose 2014 Midas+ Symposium May Tucson, AZ 19

20 Onboarding Uses of Batch Edit GME Department can use GME Batch Edit to maintain and edit their data MSS/CVO will be main user of Batch Edit, but Physician Recruiter can batch edit the data using batch edit HR may use batch edit for editing queries (criminal background checks) Onboarding Uses of Document Checklist Communication tool so other departments can view Checklist to see where the provider is in the application, recruitment, HR, or GME process All department scan view the documents sent for the organizations for which they have security Second and third notices can be sent when necessary from the Checklist 2014 Midas+ Symposium May Tucson, AZ 20

21 Onboarding Uses of Comment Templates Set up comment templates so documentation is entered consistently for: Physician Recruiter Health Plan MSS/CVO Provider Relations GME Office Onboarding Uses for Worklist Notification to MSS/CVO that an online application has been completed and ready for review Notify Health Plan that new physician has been added to the database so they can begin their process Notify Provider Relations that a provider is due for OPPE or FPPE review so a profile can be generated and shared with physician Notify Provider Relations of an upcoming provider birthday to send cards 2014 Midas+ Symposium May Tucson, AZ 21

22 Onboarding Uses of Attachments Physician Recruiter can scan in CV so MSS/CVO and Health Plan can access MSS/CVO scans in licenses, malpractice facesheet, controlled substance certificates, etc., for sharing between facilities if multi-facility database or with Health Plan Health Plan scans in contracts and supporting document ( s, applications, etc.) HR scans employment documentation Onboarding Uses of Focus Study Focus Studies allow different areas to create custom data collection forms that track particular provider information. Examples include but are not limited to: Physician Recruitment Data Collection Forms Department Chairperson Review Forms Proctoring Evaluations MSS/CVO Checklists GME Process forms 2014 Midas+ Symposium May Tucson, AZ 22

23 Onboarding Uses of ReporTrack Physician Recruiter can generate letters to prospective physicians HR can generate verification letters and welcome letters GME can generate application, letters to physicians MSS/CVO can generate verification letters, board approval letters, letters to physicians Onboarding Uses of ReporTrack (continued) PHO can generate pre-populated application (or use online application) and physician notification letters Payer Enrollment can generate pre-populated payer applications Provider Relations can print physician data sheets for distributing new provider information and notices and generate letters to providers as needed 2014 Midas+ Symposium May Tucson, AZ 23

24 Beyond Onboarding Medical Staff Leadership can review provider files electronically (inquiry only). They can complete Department Chair review forms in Focus Study Bring your laptop to Credentials Committee for electronic review. Bring up profile on the screen. Look at documentation electronically, including application, primary source verifications, reviews., profiles, etc. Accrediting agency surveys can be performed online with provider file review, generate reports as requested, show access log for OIG queries and more Beyond Onboarding (continued) As Physician Recruiter, HR, MSS/CVO, Health Plan and others enter data in Seeker, everyone else who needs that information can access it in the database including documents and scanned images. Reliance on paper and reliance on others to provide needed information is diminished Streamline your processes, save paper, access information as needed and communicate to others 2014 Midas+ Symposium May Tucson, AZ 24

25 Thanks for attending. Are there any questions? Muffie Gallardo, CPCS, CPMSM Midas+ Seeker Product Manager 2014 Midas+ Symposium May Tucson, AZ 25