Overview New and Ongoing Initiatives The Ideal Credentialing Solution NAMSS PASS
NAMSS The National Association Medical Staff Services is the professional association for 5,000 medical services professionals (MSPs) nationwide. MSPs oversee the credentialing process for licensed independent practitioners and provide operational support to the organized medical staff. NAMSS’ vision is to maximize patient care and safety through quality service delivery.
NAMSS Initiatives: Strategic Partnerships Partner with organizations with similar interests: Administrators in Medicine American Board of Medical Specialties American College of Physician Executives American Health Lawyers Association American Hospital Association AMA-OMSS American Society for Health Care Human Resources American Society for Health Care Risk Management Federation of State Medical Boards National Association for Health Care Quality
NAMSS Initiative: Payer Enrollment Issue: The current process delays practitioner onboarding and prevents timely reimbursement. Goal: Streamline payer credentialing and contracting to improve the onboarding process. Action: Review payer enrollment best-practice standards. Next Step: Reach out to industry partners to discuss and implement these best practice recommendations.
NAMSS Initiative: AHA-ACGME Residency Task Force Issue: Residency verification is not always accessible or reliable. Goal: Develop a standard primary-sourced resident verification letter. Action: Educate and help program directors access and use the letter. Next Step: Establish a strategic communication plan to educate industry stakeholders and report final outcomes.
NAMSS Initiative: The Ideal Credentialing Solution Issue: Practitioner credentialing is redundant, inefficient, and expensive. Goal: Implement best-practice standards to streamline credentialing. Action: NAMSS identified 13 primary-sourced elements critical to effective provider credentialing. Next Step: Engage industry partners for feedback and implementation strategy.
1. Proof of Identity 2. Education and Training 3. Military Service 4. Professional Licensure 5. DEA Registration and State DPS Certification 6. Board Certification 7.Affiliation and Work History 8.Criminal Background Disclosure 9.Sanctions Disclosure 10.Health Status 11.NPDB 12.Malpractice Insurance 13.Professional References The system would provide the MSP and with a complete file, including 13 pre-verified elements: The Ideal Credentialing Solution
Bringing Our Shared Vision to Reality S ource S haring A ffiliation P ractitioner
What Sets it Apart First database of its kind – complete history of practitioner affiliations (participating entities upload data free of charge). Improves patient safety and quality by facilitating comprehensive gap analysis. Eliminates redundancy and streamlines the process. Generates best-practice affiliation letters for participants. Defines “good standing.”
Practical Benefits Instantly obtain a practitioner’s affiliation history for all of the healthcare entities in which he has been credentialed, as reported by those healthcare entities. Compare and verify NAMSS PASS TM affiliation data with the application’s information. Perform a quick “gap analysis” to identify any credentialing red flags. Immediately print “good standing” letters on the letterheads of the participating hospitals, if provided.
Practical Benefits – Data Contributors Costs absolutely nothing, but provides substantial savings. Enables the contributing healthcare entity to upload current data after each board meeting (usually monthly) or more often as necessary. Eliminates individual responses to third-party requests to verify affiliation history. Each healthcare entity completely controls its data and can provide letters of good standing or direct third parties to contact the Medical Staff Office for further follow-up.
Practical Benefits – Querying Data Instantly obtain a practitioner’s affiliation history for all of the healthcare entities in which he/she has been credentialed, as reported by those healthcare entities. Compare and verify the NAMSS PASS TM affiliation information with the information provided on the application form. Perform a quick “gap analysis” to find any credentialing red flags. Immediately print “good standing” letters on the contributing facility’s letterhead, if a letter for that practitioner is available.
Additional Benefits Raises the national credentialing standard Unites the credentialing community Reduces the legal risk for negligent credentialing Provides instant verification information Improves the verification process Eliminates unnecessary costs Demonstrates MSP and practitioner collaboration
A Practitioner Profile shows a practitioner’s hospital affiliations with corresponding dates that can be verified with the practitioner’s application. Practitioner photos are available from facilities that provide them.
A good-standing letter can be immediately printed. NAMSS Board and healthcare law firm, Horty, Springer, & Mattern, designed two template letters for facilities. If a letter is not available, the user can directly contact the facility.
What are the Fees? Basic Service at No Charge Contribute Affiliation Data No Charge Add Additional Users No Charge Browse Practitioners and Facilities No Charge Auto-Response Print of Your Good Standing Letters to Other Entities No Charge
Rollout Pilot Program Began: SEPTEMBER 2012 Pilot Completed: DECEMBER 2012 Made Available to All MSPs: JANUARY 2013
As of November 2013 (to be updated) Over 260 participating entities and growing weekly Over 202,000 affiliations Over 100,000 practitioners Health-system participation: Johns Hopkins Swedish American Health System Aurora Healthcare Centura Health Wheaton Franciscan Healthcare WakeMed Health Bon Secours Health System Summit Health Froederdt Health Hawaii Health Systems Corporation
NAMSS’ Next Steps Reach out to industry partners to discuss our Payer Enrollment best-practice recommendations. Work with the ACGME Residency Task Force to educate stakeholders and report final outcomes. Engage industry partners to discuss the Ideal Credentialing Standards’ implementation. Engage industry partners on future initiatives and ideas.
NAMSS Contacts: John R Pastrano Director, Medical Staff Services Centennial Medical Center John.Pastrano@tenethealth.com John.Pastrano@tenethealth.com Lynn Boyd Executive Director, NAMSS firstname.lastname@example.org John Richardson Director, NAMSS Government Relations email@example.com