According to one estimate, Americans wait their turn in real or virtual lines a collective 37 billion hours a year—or 118 hours per person per year. If you’re in the professional group of payer/provider enrollment specialists that interfaces with insurers daily, your number might be a lot higher.
Playing Fortnite or doing the NYT mini-crossword are good distractions when you’re on your own time, but at work you’ll want something a bit more productive while you wait.
The following “project starters” will help productivity and polish your profile at work while you wait for payers:
1. Toward going paperless: If you’re starting from scratch, document your workflow to determine how it will change when a paper application no longer exists. You can do this in parts to catch everything—for example from the provider’s perspective and then from the office’s perspective.
More advanced? Draft what your internal indexing system for providers will look like. Set up a mock electronic file for each enrolled/credentialed provider and arrange it like a traditional paper credentialing file. Then draft a standardized naming convention for each provider and each document in the file.
2. Toward integrating credentialing and enrollment: Get a hold of your counterpart in the organization or system who conducts recruiting, onboarding, and/or credentialing/privileging. Ask them for an itemized list of what items, material, signatures, etc., are collected during their processes, then compare to see where efforts can shared or eliminated.
Use our handy matrix to see where duplication occurs!
3. Toward developing key productivity metrics: Pick 2-3 to start for your department and start tracking:
- Turnaround time for application from provider: Check your application’s instructions for clarity and expected turnaround time. Assess the ability to offer online applications using the software or resources you have. Highlight any items that can be completed by the department and not the provider.
- Completion rate of application by the provider/Average time to submit completed applications to the payers: Look at your universe of payers to identify which payers have the exact same or very similar requirements. Prioritize which payer request items across the board take less time and can be knocked off first.
- Turnaround time from payers: Get a simple spreadsheet going to track denials, rejections, data errors (typos), and procedural errors (missed deadlines). Once you have some data in the bag, put a star next to the most frequent pain points causing lost time from each payer.
4. Toward maximizing your software: Ask your vendor for a complimentary analysis of your PE workflow to discover database functionality you aren’t maximizing, using correctly—or perhaps don’t even know about. Check: auto-population, batch/bulk updates, and notifications, to name a few.
5. Toward collecting team feedback for/about payers: Institute a payer report card. Perhaps you can use it when renegotiating with payers. Perhaps not and it serves as internal intelligence tool. Filling out our sample payer report card will surely make you feel better at the very least.
Here’s to maximizing your wait time to make it work for you!