“The goal is to turn data into information, and information into insight.” – Carly Fiorina, former CEO of HP
“In God we trust. All others must bring data.”– W. Edwards Deming, statistician, engineer, author
“If we have data, let’s look at data. If all we have are opinions, let’s go with mine.” – Jim Barksdale, former Netscape CEO
It’s much more than just “data in, data out.” Medical credentialing and enrollment professionals know better than most: 1) Data collection and 2) data entry are half the battle. After that, there’s 3) analyzing, 4) deciding, and 5) and executing. If you’re a visual learner, picture the MSP grabbing that provider data by the ankles and shaking it upside down to see what falls out of its pockets.
Success for credentialers is applying and interpreting data so that no practitioner achieves the ability to provide a service or perform procedure, be on an insurance panel, or join a medical staff until they’ve proven to have met certain milestones. In other words, when data is of excellent quality, it can be easily processed and understood. It can be shared and interpreted to aid in making the best decisions possible. When the data’s bad, healthcare safety and quality are in jeopardy.
The checks on provider data according to internal specifications and external guidelines is also known as quality assurance (QA). It’s not in your title or perhaps even on your job description, but you’re a credentialing data quality assurance specialist.
Is your QA process cursory or comprehensive? This week’s blog provides a starting point (or a checkup) for the initial phases of data treatment in the verification and enrollment phases. Click here to download a sample QA process for data entry prior to PSV.