Mitigating Lost Revenue, Ensuring Regulatory Compliance, and Improving Patient and Provider Satisfaction

THE SITUATION

A significant backlog of provider initial and reappoint-ment applications can lead to delays in credentialing, privileging, and enrollment turnaround time, resulting in lost revenue and patient and provider dissatisfaction. A large healthcare system —consisting of hospitals, physician practices, clinics, and health plans —came to Hardenbergh Group facing a backlog of 1,700 initial applications, 300 reappointments, while also having a need to audit delegation contracts. Further, a regulatory audit and survey were scheduled to take place in three months.

THE SOLUTION

The health system realized the benefit of quickly augmenting their staff with temporary, qualified Medical Services Professionals (MSPs) and reached out to Hardenbergh to help. A team of Credentialing Coordinators, Auditors, Team Leads and a Project Manager was assembled to meet the client’s specific requirements.

The team leveraged established, internal processes and the client’s cloud-based software, MD-Staff, to track critical data and provide reporting on KPI’s and compliance metrics. Within a condensed project timeline, Hardenbergh completed 100% of the client’s backlogged applications and delegation audits, and the client successfully passed both the regulatory audit and survey. In addition, at the end of the project, the health system was 3 months ahead on reappointments.

OUR APPROACH

Through a multi-phase discovery process, Hardenbergh provided an assessment of the client’s provider credentialing and enrollment/managed care process. Qualified candidates with relevant skills, expertise and software proficiency were identified from Hardenbergh’s network of over 2,000 MSP’s. Within one week, the team was onboarded and working the backlog of applications.

END RESULT

Hardenbergh’s interim CVO model provided the additional flex resources needed to stabilize the client’s operations and eliminate the backlog of files, while effectively managing costs. The successful outcome was driven by efficient and high-quality service delivery, the rapid mobilization of experienced and knowledgeable MSPs, and effective CVO workflow management.

At the conclusion of the project, the client commented:

“Our reappointment team is caught up for the first time in two years.”