Thought Leadership

New Perspectives To Improve the Credentialing Industry

University of Pennsylvania Health System – Academic Medical Center

The University of Pennsylvania Health System (Penn Medicine) is a world-renowned academic medical center dedicated to discoveries that advance science, outstanding patient care throughout the world, and the education of physicians and scientists who carry on its legacy of excellence. The organization has nearly 2,000 physicians between its primary care network and faculty practice plan.

Like many faculty practice plans and physician organizations that have evolved over the years, Penn Medicine had created and maintained a large number of tax IDs. Greater than 30 different tax IDs were in use with all of the revenue ultimately being owned by the Trustees of the University of Pennsylvania. With the significant increase in Electronic Medical Record (EMR) integration along with increasing regulatory requirements focusing on quality (Meaningful Use, Value Based Modifier, etc. ), the existing structure no longer works. Reporting patient services under different tax ID’s did not properly reflect Penn Medicine’s integrated approach to the care they provide their patients.

Penn Medicine was faced with the enormous undertaking of paring down its faculty practice plan tax ID numbers from 32 to one and needed additional and experienced resources to complete the task within the desired timeframe. Penn Medicine partnered with Newport Credentialing Solutions to manage and complete the task.

Highly experienced staff provides necessary resources

Familiar with Newport and its reputation for excellence in credentialing and provider enrollment, the Senior Director of Patient Accounting at Penn Medicine, Steven Honeywell, enlisted Newport’s services. The project began in February 2015, and needed to be affective with dates of service starting May 1st 2015.

Newport’s deep knowledge of the provider enrollment process and established relationships with payer groups proved to be a huge asset for the project. The consolidation required Newport to work with Penn Medicine’s large number of payers (including Medicare, Independent Blue Cross and all other Blues Plans, Aetna and many others). Newport was involved in the process to create new national provider identification numbers (NPIs) and make sure the group NPI’s and Physicians were correctly associated with our designated tax ID number.

The project was a massive undertaking that required diligent follow-up. If NPIs were not set up correctly in the payers’ systems, the claims would go unrecognized, and potentially not paid. The team at Newport has proven they have the knowledge, the resources, and the follow-through to meet the demands of this cumbersome task.

According to Honeywell, to undertake a project of this size internally Penn Medicine would have had to hire additional staff specifically for the duration of the project. Even with the added resources, without the knowledge and experience that Newport’s staff brought to the table, it would have taken the Penn Medicine team significantly longer.

Spotlight Quote: “Newport brought the much-needed resources and expertise necessary to handle this very demanding project. They work with payers every day along with our internal resources. They know the right contacts at the payers, and they know how the provider enrollment industry works. The staff at Newport are great to work with and very diligent with follow-through. It is clear they know their stuff, and I could not be more pleased with the services Newport provides,” concluded Honeywell.

Download

Click here to download the PDF.

Logo Header Menu