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Welcome to the 12th Annual Health Line Systems ™ Client Strategy Conference

Welcome to the 12th Annual Health Line Systems ™ Client Strategy Conference. October 24-25, 2001 Hyatt Regency Chicago, IL. Today’s Objectives. Demonstrate time-savers to help the “understaffed” office meet objectives with current staff

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Welcome to the 12th Annual Health Line Systems ™ Client Strategy Conference

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  1. Welcome to the 12th Annual HealthLine Systems™ Client Strategy Conference October 24-25, 2001 Hyatt Regency Chicago, IL

  2. Today’s Objectives • Demonstrate time-savers to help the “understaffed” office meet objectives with current staff • Identify new ways to use MSLW/Echo to reduce costs • Explore changes in technology & regulatory requirements • Identify & share “best practices”

  3. The Actions • Four in-depth, practical sessions • Three relevant case studies • Networking opportunities • Review of the OIG program • HealthLine Systems’ future plans

  4. Credentialing Past & Present • Fundamentals of credentialing remains unchanged from the typewriter & file cabinet days: • Verify everything • Verify as quickly as possible • Grant privileges specific to the providers education and training • So what does the future hold?

  5. The Challenge for MSSP’s Retention of files Allied Health Locum Tenens Lack of staff Background checks Technology JCAHO, NCQA, URAC Privileges - Core, Temp’s, Lists HIPAA

  6. Do More with Less • Credentialing is a labor & materials intensive process. For example: • $463.00 to process a new applicant • Administrative overhead -- $103.00 • Staff time -- $322.00 • Verification costs $38.00 • Staff time & overhead = 90%

  7. Electronic Credentialing • More electronic sources now available - over 50 internet sources • Online applications slowly gaining acceptance • Scanned copies eliminates paper

  8. More Requests for Information • More organizations requesting ‘detailed’ information • Dissemination of ‘real-time’ clinical privileges • Internet based ‘auto-verify’ • Intranet based R & R’s, bylaws, calendars • Online status checks

  9. Economies of Scale • “Standardized” state-wide applications (4 mandatory, dozens voluntary) • VetPro - the VA data bank • CAQH common database • Centralized credentialing, particularly for health system with MCO’s

  10. According to the Crystal Ball • 2005 - 100% electronic credentialing • QA data electronically shared • Federal data sources provide immediate reports • PDA’s used to view information

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