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  • Dilsa S. Bailey, CPMSM

Medical Services Professionals Should Never Stop Looking for Opportunities for Improvement



Whether things are going as smoothly as a well-oiled machine or overflowing with chaos in your office, there are always opportunities for improvement. It doesn’t matter if you run the credentialing department, the medical staff services office, or the payor enrollment division, you can always find a better way to perform a task, to meet a goal, or to encourage your staff. That’s why performance improvement should still be a top priority. That benchmark for high-quality service and production should always be moving upward; even it is only climbing an inch at a time. But, the endeavor to reach higher should never, ever make you or your staff stressed out just thinking about it. Determining where you can improve does not have to be daunting and complicated. Keeping an eye on your daily operations, what is working and what is not working, should be kept simple.

For instance, numbers always work in identifying what areas suffer the most or excel the most. Do you track the volume of what you do? Do you compare the volumes for previous years during previous similar or same months? Do you analyze the volumes across specialties and your staff performing related tasks? Are there trends? Does someone in your office utilize the tools available more efficiently than someone else? Are the numbers in your reports telling you someone needs more training, or someone has just checked out on the job? So many questions, so many observations can be based on the proper analysis of the data collected.

How do you collect the data? If you are correctly utilizing a database, you can pull reports after you have determined what needs to be tracked. Establish two short sets of data that you want to collect. One set should be queried and reviewed monthly, the other quarterly to give you an overall perspective of how well your department is performing. The sets could include the average length of time it takes to collect data after receiving a complete application, or how long it takes to verify specific items. What percentage of these files were processed outside of the established benchmarks? How long did the file sit before it was assigned? Did the notification timeframe meet the appropriate criteria? Was there any fallout? How many files were audited? There are many elements that can be used to track productivity and service. Just talk them through and formalize them as consistent measurements. Then, these measurements will give you the most accurate picture of your department’s health. Once you have aggregated the data collected, then the task is to determine the opportunities for improvement and barriers, if any, from pursuing those opportunities or preventing your team from achieving its goals. If you need help from an outside department or source to get things done properly, don’t be afraid to ask. You will be better off for raising your hand than just helplessly watching the numbers bring your operations to a halt or devolve it into a chaotic state. That’s not what we do as professionals. Medical Services Professionals keeps everything on track.

Dilsa S. Bailey, CPMSM is the owner and principal consultant for The Right Credentials Network. If your credentialing and provider enrollment programs need assistance, contact The Right Credentials Network. We can help you apply for and maintain accreditation as well as repair your existing program. And, if you or your staff needs additional training, join us for our webinars, training modules, and various events.


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