Thought Leadership

New Perspectives To Improve the Credentialing Industry

Category: Patient Satisfaction

3 Tips to Avoid Post-M&A Revenue Disruptions

As seen in Becker’s Hospital CFO Report: Written by Scott Friesen, CEO of Newport Credentialing Solutions Healthcare merger and acquisition (M&A) activity is at an all-time high. For hospitals and health systems looking for new ways to stay competitive and expand their offerings, mergers and acquisitions have become a viable option. While healthcare organizations have… Read More

As seen in Becker’s Hospital CFO Report: Written by Scott Friesen, CEO of Newport Credentialing Solutions

Healthcare merger and acquisition (M&A) activity is at an all-time high. For hospitals and health systems looking for new ways to stay competitive and expand their offerings, mergers and acquisitions have become a viable option.

While healthcare organizations have gotten better at post-M&A integration throughout the years, it is not uncommon for revenue disruptions to occur because of an oversight. One common area that is often overlooked is provider data management (PDM). When provider contracting and data management are not factored into M&A integration plans, hospitals and health systems put themselves in a costly financial position.

To avoid post-M&A revenue disruptions associated with provider data management integration issues (this includes credentialing and provider enrollment), consider the following…

 
 

Click here to finish reading the full article…
 
Becker’s Hospital CFO Report is the original producer of this publication.
 
 

Doctors Without Dashboards

As seen in Exago: Written by Nicole Hitner Things change slowly in the healthcare industry, but according to Newport Credentialing VP Technology David Meier, they are changing—and for the better. Before the Affordable Healthcare Act (ACA) became law in 2010, patients, care provider groups, and insurance companies were in a three-way tug of war over… Read More

As seen in Exago: Written by Nicole Hitner

Things change slowly in the healthcare industry, but according to Newport Credentialing VP Technology David Meier, they are changing—and for the better.

Before the Affordable Healthcare Act (ACA) became law in 2010, patients, care provider groups, and insurance companies were in a three-way tug of war over finances, each party trying to get the highest return on its investment. Although the country’s quest for an optimized healthcare system continues, Meier says the tone of the conversation has moved away from competition and toward patient-centered systems such as value-based care, a more holistic alternative to fee-for-service payment models.

“There has been a major shift in the industry as a whole,” says Meier. “Before, these three groups had their own agendas and didn’t really work well together. Now, provider organizations are working to align with patients’ needs in order to keep them healthy and happy.”

This paradigm shift has had a major impact on healthcare information systems. Now, more than ever, federal regulators are enforcing data integrity standards and holding providers and insurers accountable for their records, putting companies like Newport Credentialing at the center of the action.

Newport Credentialing Solutions produces CARE, a cloud-based credentialing and provider enrollment application complete with workflows, analytics, and business intelligence. Medical groups use CARE to manage their relationships with insurers like MVP and UnitedHealth. Because the providers, or doctors, in each group must enroll with each insurer separately, the recordkeeping is extensive. Not only that, but each insurer has its own requirements for when and how often providers need to update their information, as governmental penalties for inaccuracy are passed down through the insurer to the doctors themselves.

“It’s really become more and more important that the data that we’re providing to the health insurance plans is accurate,” says Meier. “And this is where business intelligence really fits into the whole thing.”

According to Meier, modern solutions like CARE find themselves thrust into an ecosystem of disjointed technologies. Although provider groups are continuing to consolidate into larger medical groups, their backend processes and programs are failing to keep pace. As a result, providers often have no way to visualize or even query their data themselves.

In these conditions, even running simple reports is an ordeal. “Let’s say a medical group wants to see all their providers and the locations where those providers are seeing patients,” Meier offers by way of example. “Usually what happens is they have to put in a request to IT, IT has to go into an approval process that then gets slated for work, and then it takes two or three weeks for them to start working on the order. Maybe it’s eight hours worth of effort. The group needs something tomorrow, but they’re not going to get it for a month and a half. And that’s not exaggerating.”

When Newport comes on the scene, its business intelligence capabilities change all this for the client organization. Where before providers were relying on spreadsheets and black boxes, now they are able to access, visualize, and report on their data. Some even elect to use CARE’s ad hoc reporting tool to build custom reports on the fly.

As exciting as this newfound freedom is for provider groups, Meier sees BI’s impact on data management as even more significant. CARE connects to a variety of platforms including billing, HR, privileging, and central verification office systems. In many cases, these systems do not interface with each other, and their manually-entered data is rife with inconsistencies. As the reporting hub and common link between these disjointed systems, CARE often becomes the “source of truth” for provider groups, writing cleansed data to the other systems in the network.

“Although provider data management hasn’t historically been a central tenet of provider enrollment, we realized early on that it needed to be,” Meier explains. “Organizations need to centralize this data somewhere. It can’t be in a hundred different systems throughout the organization, and you can’t filter on a location if you have fifty different ways of spelling it.” BI by its very nature is compelling healthcare organizations to clean up their data practices.

But BI is also helping Newport speed up some of the bureaucratic processes that have been holding healthcare back in the first place. With hard data their fingertips, CARE agents are able to tell medical groups how long it takes them to, for example, complete a step of the enrollment process and flag possible inefficiencies. “It was taking around 45 days for one of our clients to get information back to us,” relates Meier. “We showed them this because we have the data and, in doing so, we cut that down to about 12 days.”

For Meier and the rest of the Newport team, these kinds of victories are ultimately about providing better care. If healthcare 1.0 was about profit, then healthcare 2.0 is, as Meier puts it, about “prioritizing patient health.”

“There are downstream effects for everybody,” he says. “For us, it’s managing data and making sure that provider data is as accurate as possible.”

Exago is the original producer of this publication.

How Silos Restrict Key Information Sharing Within Hospitals

As seen in Health Data Management: Written by Scott Friesen The healthcare industry is undergoing a massive change as it transitions toward a connected network of clinical and administrative services, with the goal of improving patient quality and clinical outcomes. However, as demonstrated through electronic health record systems utilization, an interconnected network can be a… Read More

As seen in Health Data Management: Written by Scott Friesen

The healthcare industry is undergoing a massive change as it transitions toward a connected network of clinical and administrative services, with the goal of improving patient quality and clinical outcomes. However, as demonstrated through electronic health record systems utilization, an interconnected network can be a complex endeavor.

The rush to deploy EHR systems was driven largely by the Centers for Medicare and Medicaid’s Meaningful Use federal incentive program. Huge financial incentives helped speed the transition from paper to digital records. While great strides have been made in this transition, a new light has been cast on EHRs and the significant interoperability challenges that continue to exist.

Technology is rapidly advancing, and vendors have learned a lot from EHR deployments. Arguably, the biggest lesson is to address the continued need to easily share data between disparate systems. After all, no matter how much data is captured within a system, its value is greatly diminished when it can’t be shared with other systems, groups and organizations. When left in their separate data silos, resources, outcomes, revenue and other areas are negatively impacted.
 
 
Click here to finish reading the full article…
 
Health Data Management is the original producer of this publication.
 
 

How Provider Enrollment Impacts Patient Satisfaction

As seen in Becker’s Hospital Review: Written by Scott Friesen, CEO of Newport Credentialing Solutions The rise of healthcare consumerism has significantly elevated the importance of patient satisfaction. As deductibles continue to climb, patients have become increasingly more vocal in their care and choice of provider. If they aren’t happy, they will take their business… Read More

As seen in Becker’s Hospital Review: Written by Scott Friesen, CEO of Newport Credentialing Solutions

The rise of healthcare consumerism has significantly elevated the importance of patient satisfaction.

As deductibles continue to climb, patients have become increasingly more vocal in their care and choice of provider. If they aren’t happy, they will take their business elsewhere, often leaving a negative online review in the process.

As hospitals and health systems continue to look for new ways to improve patient satisfaction, one area that is typically overlooked is provider enrollment. While commonly viewed as a back-office function, provider enrollment can have a significant impact on patient satisfaction and the overall hospital experience. If a provider is not enrolled with their respective provider, the patient…
 
 
As seen in Becker's Hospital ReviewClick here to read the full article…
 
Becker’s Hospital Review is the original producer of this publication.
 
 

160+ Healthcare Revenue Cycle Companies to Know

As seen in Becker’s Hospital Review: Written by Laura Dyrda
Hospitals, health systems, physician practices and healthcare organizations are experiencing increasingly complex revenue cycles, working with government and private payers as well as patients to collect. Here are more than 160 companies with revenue cycle management solutions in the healthcare space… Read More

As seen in Becker’s Hospital Review: Written by Laura Dyrda

Hospitals, health systems, physician practices and healthcare organizations are experiencing increasingly complex revenue cycles, working with government and private payers as well as patients to collect. Here are more than 160 companies with revenue cycle management solutions in the healthcare space.
 
 
As seen in Becker's Hospital ReviewClick here to read the full article…
 
Becker’s Hospital Review is the original producer of this publication.
 
 

2017 September Newsletter: In Case You Missed It

Newport Credentialing: In Case You Missed It For Newport, the past two months have been very busy and exciting preparing for fall! We were featured in several articles, partnered with new healthcare organizations, continued our webinar series, and much more. Below are a few additional highlights of our successes.   Featured in Becker’s Hospital Review:… Read More

Newport Credentialing: In Case You Missed It

For Newport, the past two months have been very busy and exciting preparing for fall! We were featured in several articles, partnered with new healthcare organizations, continued our webinar series, and much more. Below are a few additional highlights of our successes.
 

Featured in Becker’s Hospital Review: Key Considerations When Selecting a Credentialing Company

Outsourcing your credentialing and enrollment process is a much easier and cost-effective option compared to managing the process in-house. In this article, find out what to consider when selecting a partner.
Read the full article here.
 
 

Featured in Becker’s Hospital CFO Report: RCM Tip of the Day

Are you underestimating the importance of participating and nonparticipating analysis? Click here to read Becker’s RCM Tip of The Day featuring Newport Credentialing!
Read the full article here.
 
 

Lina Monterosso Shares her Experience Working with Newport

Lina Monterosso, former VP Revenue Management at FOX Rehabilitation, has first-hand experience partnering with Newport Credentialing. See what she has to say about her experience.
Read the full article here.
 
 

Hosted a Webinar for Federally Qualified Health Centers


In August, Newport hosted a 30-minute webinar for FQHCs helping educate them on how to improve their provider enrollment process with just five actionable tips.
To receive a copy of the presentation, please send us an email.
 
 

Join our Growing Team!

Newport is hiring Credentialing Specialists, Account Supervisors, and Data Entry Specialists. To apply, please submit a copy of your resume to careers@newport.theadleaf.com. For more information about the jobs available, visit our Careers page.

See What Our Clients Are Saying: Atlanticare

Tony Cottone, former Director of Revenue Cycle at AtlantiCare, implemented our credentialing and provider enrollment services at APG, vastly improving processes and increasing revenue. See what he has to say about his experience… Read More

Tony Cottone Former Director of Revenue Cycle; Consultant Atlanticare Physician Group

Tony Cottone, former Director of Revenue Cycle at AtlantiCare, implemented our credentialing and provider enrollment services at APG, vastly improving processes and increasing revenue. See what he has to say about his experience.

 
 

See What Our Clients Are Saying: FOX Rehab

Lina Monterosso, VP Revenue Management at FOX Rehabilitation, has first-hand experience partnering with Newport Credentialing. See what she has to say!… Read More

Lina Monterosso: VP Revenue Management Fox Rehabilitation

Lina Monterosso, VP Revenue Management at FOX Rehabilitation, has first-hand experience partnering with Newport Credentialing. See what she has to say!.

 
 

DOWNLOAD: The Invisible Impact of Credentialing

Are you aware of the impact credentialing can have on your healthcare facility? In Newport’s latest eBook, The Invisible Impact of Credentialing, we help bring awareness to the many invisible “touches” credentialing has on technology, patient satisfaction, revenue enhancement, and much more. The eBook is packed with actionable items you can start implementing today to… Read More

Are you aware of the impact credentialing can have on your healthcare facility?

In Newport’s latest eBook, The Invisible Impact of Credentialing, we help bring awareness to the many invisible “touches” credentialing has on technology, patient satisfaction, revenue enhancement, and much more. The eBook is packed with actionable items you can start implementing today to make a positive change at your facility.
 
Click Here to Download Now!

 
 
 
 

The Invisible Impact of Credentialing: Tip 4

Tip 4: Consider Overlooked Costs. Denied claims caused by credentialing-related issues have an obvious impact on a provider’s reimbursements. With limited exception, the inability to collect on these denied claims often leads a provider’s practice to write off the claim and stop the pursuit of reimbursement. Given just how many patient encounters a provider has… Read More

Tip 4: Consider Overlooked Costs.

Denied claims caused by credentialing-related issues have an obvious impact on a provider’s reimbursements. With limited exception, the inability to collect on these denied claims often leads a provider’s practice to write off the claim and stop the pursuit of reimbursement. Given just how many patient encounters a provider has in a given day, week or month, the financial impact of having to write off an encounter can be significant.

Practices go to great lengths to ensure a patient’s insurance is verified well in advance of an encounter. If he or she isn’t covered, the procedure isn’t done. While the financial implications of having to write off an encounter are well known, it is surprising that many practices are overlooking another process equally as important as insurance verification – credentialing and provider enrollment verification. To change the way credentialing and provider enrollment are viewed, quantifying lost dollars is essential… [click here to download].

Looking for additional tips?

To download Tip 1, please click here.
To download Tip 2, please click here.
To download Tip 3, please click here.

 

The Invisible Impact of Credentialing: Tip 3

Tip 3: Prevent Surprise Medical Billing.   In 2016 a number of states across the US enacted laws aimed at shielding patients from surprise medical bills.These laws have been enacted to protect insured patients from surprise medical bills when services are performed by an out-of-network provider at an in-network hospital or outpatient services location covered… Read More

Tip 3: Prevent Surprise Medical Billing.

 
In 2016 a number of states across the US enacted laws aimed at shielding patients from surprise medical bills.These laws have been enacted to protect insured patients from surprise medical bills when services are performed by an out-of-network provider at an in-network hospital or outpatient services location covered in their health insurance plan or when a participating provider refers an insured patient to a non-participating provider. Surprise medical bills are most often associated with emergency care, when a patient has little to no say in their care-plan. Items may include ambulances, anesthesiologists, radiology, etc. Surprise medical billing can also occur when a patient receives scheduled care from an in-network provider.

When healthcare providers are not enrolled properly with one or more health plans in which they participate, or if they have inadvertently allowed their enrollment status to lapse, billing disruption is inevitable… [click here to download].
 
 

Looking for additional tips?

To download Tip 1, please click here.
To download Tip 2, please click here.

 
 

The Invisible Impact of Credentialing: Tip 2

Tip 2: Make Sure All Data is Protected – Not Just PHI.   More than two decades ago, the Health Insurance Portability and Accountability Act (HIPAA) was signed into law. One of its most significant provisions was to create a standard method of protecting patient data, regardless of where it resides. In 2000 additional safeguards… Read More

Tip 2: Make Sure All Data is Protected – Not Just PHI.

 
More than two decades ago, the Health Insurance Portability and Accountability Act (HIPAA) was signed into law. One of its most significant provisions was to create a standard method of protecting patient data, regardless of where it resides. In 2000 additional safeguards were put in place and Protected Health Information (PHI) became the responsibility of everyone in the healthcare sector. As a result…

[click here to download].
 
 

Looking for additional tips?

To download Tip 1, please click here.
 
 

The Invisible Impact of Credentialing: Tip 1

Tip 1: Credentialing Can Disrupt Your Patient Satisfaction Outcomes.   With the advent of Accountable Care Organizations (ACOs) and population health management initiatives, healthcare organizations are increasingly implementing technology and processes to encourage patient engagement. Incumbent in these efforts is the collection of more patient satisfaction data to help yield better decision making to promote… Read More

Tip 1: Credentialing Can Disrupt Your Patient Satisfaction Outcomes.

 
With the advent of Accountable Care Organizations (ACOs) and population health management initiatives, healthcare organizations are increasingly implementing technology and processes to encourage patient engagement. Incumbent in these efforts is the collection of more patient satisfaction data to help yield better decision making to promote lower cost delivery models and better clinical outcomes throughout the communities they serve.

As providers in all healthcare delivery networks strive to enhance patient satisfaction scores, they are all too often burdened by… [click here to download].
 
 

Looking for additional tips?

Over the coming months, Newport will provide a 4 part Tips Series which focuses on the invisible impact of credentialing. Check back soon!
 
 

Scott Friesen Recognized by Becker’s Hospital Review

As seen in Becker’s Hospital Review: 137 Healthcare Entrepreneurs to Know Our CEO, Scott Friesen, was recently honored by Becker’s Hospital Review as a leading entrepreneur in the healthcare space. The article recognizes those who are paving the way through innovation in the medical, IT, consumer and medical professional fields. Congratulations Scott!     Click… Read More

As seen in Becker’s Hospital Review: 137 Healthcare Entrepreneurs to Know

Our CEO, Scott Friesen, was recently honored by Becker’s Hospital Review as a leading entrepreneur in the healthcare space. The article recognizes those who are paving the way through innovation in the medical, IT, consumer and medical professional fields. Congratulations Scott!
 
 
Beckers Hospital ReviewClick here to read the full article.

Becker’s Health IT & CIO Review is the original producer of this publication.
 
 
 

2016: Conferences, Webinars, Newsletters, and more!

Here’s what Newport Credentialing has in store for 2016!   Conference Schedule AMGA National Meeting March 8th – 12th, 2016 Orlando, FL       Becker’s Hospital 7th Annual Meeting April 27th – 30th, 2016 Chicago, IL       HFMA Annual Conference June 26th – 29th, 2016 Las Vegas, NV       MGMA… Read More

Here’s what Newport Credentialing has in store for 2016!

 

Conference Schedule

Newport AMGAAMGA National Meeting
March 8th – 12th, 2016
Orlando, FL
 
 
 
Newport BeckersBecker’s Hospital 7th Annual Meeting
April 27th – 30th, 2016
Chicago, IL
 
 
 
Newport HFMAHFMA Annual Conference
June 26th – 29th, 2016
Las Vegas, NV
 
 
 
Newport MGMAMGMA National Meeting
October 30th – November 2nd, 2016
San Francisco, CA
 
 
 
More State & Regional Conferences Announced in 2016!
 
 

Webinar Schedule

Credentialing & Provider Enrollment 101
February 16th, 2016
Registration begins January 11th

Provider Enrollment Technology Solutions – The Right Tool for the Job Matters
March 17th, 2016
Registration begins February 12th

More to come! Further webinars will be announced.
 
 

Newport Quarterly eNewsletter

Each quarter, beginning in March 2016, Newport Credentialing Solutions will produce an informative eNewsletter to spotlight healthcare related issues with a focus on revenue cycle management. Our editorial staff will be working with some of Newport’s key customers and industry thought-leaders to bring a timely and insightful perspective on emerging trends in healthcare management best practices.

We want to hear from you…
 
We are in the process of building out our 2016 webinars, newsletters, and thought leadership pieces, and we would love your input on what topics would be of most interest to you. Please click here to submit any suggestions or ideas. Thank you!

 
 

Credentialing Implications on Patient Satisfaction

With the advent of Accountable Care Organizations (ACO’s) and population health management initiatives, healthcare organizations are implementing technology and process solutions designed to encourage patient engagement. Incumbent in these efforts is the collection of more patient satisfaction data to help yield better decision making to promote lower cost delivery models and better clinical outcomes throughout… Read More

With the advent of Accountable Care Organizations (ACO’s) and population health management initiatives, healthcare organizations are implementing technology and process solutions designed to encourage patient engagement.

Incumbent in these efforts is the collection of more patient satisfaction data to help yield better decision making to promote lower cost delivery models and better clinical outcomes throughout the communities they serve.

As providers in all healthcare delivery networks effort to enhance patient satisfaction scores, they are all too often burdened by events that occur outside the scope of treatment. Parking convenience, patient wait times, and the perception of a courteous medical staff all impact the patient’s experience and the way they express their level of satisfaction. One often overlooked scenario impacting patient satisfaction is the credentialing and enrollment status of a provider that is assumed – both by provider and patient – to be in a payer’s network.

When a provider’s participation status with a health plan is disrupted – which could stem from a failure to adequately monitor expiring documents, errors in the initial/ re-enrollment process, or failing to identify all locations where that provider will see patients – the patient may face a denied claim for utilizing “out-of-network” services or be told by their health plan that they are responsible to pay higher co-insurance levels than previously disclosed. Since the patient is generally held harmless in these scenarios, most providers will quickly work with the patient and write-off these charges. However, the patient’s experience in these instances is generally unfavorable regardless of the financial outcome or impact they ultimately realize.

What compounds the problem in this scenario is the failure to record the root cause of a patient’s dissatisfaction. Unless a patient takes time to write a narrative describing this scenario, most survey forms will not specifically address credentialing related issues and the patient’s dissatisfaction can manifest in other metrics that are monitored. This leaves the organization with a skewed data set of unfavorable survey outcomes and an inability to take appropriate corrective actions.
 

About the Author

Patrick Doyle is the Vice President of Business Development for Newport Credentialing and has over 20 years of experience in healthcare IT and revenue cycle solutions.

About Newport Credentialing Solutions

Newport Credentialing Solutions is the nation’s premier provider of cloud based software and IT enabled services dedicated to the credentialing life cycle. Newport provides cloud based workflow, analytics, and business intelligence credentialing software and IT enabled credentialing services to some of the largest academic medical centers, health systems, and multi-­‐‑ specialty group practices in the United States. Newport helps clients “Take Control” over their credentialing life cycle by streamlining operations, reducing credentialing related denials, and generating more cash for their organization.

For more information on Newport’s software and service solutions, please contact 516.593.1380 or info@newport.theadleaf.com.

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