Introducing CMS Credentialing and Enrollment Services powered by 3WON

Wednesday, November 01, 2017 02:57 PM

The problem 

According to a 2014 survey of American Physicians, conducted by The Physicians Foundation and Merritt Hawkins, the amount of time spent on non-clinical paperwork throughout the year is equivalent to reducing the practicing physician population by as many as 161,000 physicians and shrinks the time available to see patients by more than eight million hours annually. Today, most hospital credentialing is decentralized and an independent process for each hospital and often from department to department within a hospital. Complying with all the requests for information costs the average physician practice in excess of $2,500 per year. Compliance suffers as well, since physicians are frustrated and inundated with multiple requests for the same information from a myriad of sources.

The solution 

The Colorado Medical Society (CMS) has a solution unique to the health care industry and a game-changer on how practitioner data is gathered, maintained and distributed to the health care ecosystem and the general public. CMS Credentialing and Enrollment Services reduces unnecessary paperwork and increases practice revenue while improving data quality with reduced time, effort and expense. The service, a joint venture with 3WON, employs a proprietary SaaS based software known as ProStat, which is a physician-centric technology solution designed to aggregate, cleanse, monitor and validate data from the practitioner and multiple other data sources. 

Using a single standardized platform for entering, maintaining, verifying and distributing data saves time and money for physicians and increases the quality and timeliness of the data. Using 3WON’s SmartForm, the practitioners enter, verify, edit and update their data. A data validation tool prevents incomplete forms from being submitted, which is the number one reason for delay in health plan enrollment. 3WON’s certified credentialing staff then reviews all data for completeness, accuracy and verification before sending to hospitals, health systems, public and private health plans and state and federal regulatory agencies. 

By migrating practitioner credentialing and enrollment to real-time management, the CMS service can provide all entities with up to date and timely profile information concerning medical professional credentials and keep them in the loop as changes occur. The process proactively alerts medical professionals and their staff to ensure they are aware of their expirable information, reappointment and re-enrollment requirements. Centralizing data collection, management, and distribution substantially reduces the number of outreaches to physicians for their data. The information is maintained and updated in near real-time so that when required for credentialing, re-credentialing or enrollment it can be immediately accessed and provided. Document management is automated and most attestation is electronic.