MMA News
Online Credentialing Gains Momentum
The work of the MMA and its partners to establish a statewide credentialing collaborative is starting to pay off, as more than 4,400 physicians and other health care practitioners, 14 hospitals, and all seven of Minnesota’s nonprofit health plans have joined the Minnesota Credentialing Collaborative (MCC).
The MMA, the Minnesota Hospital Association, the Minnesota Council of Health Plans, and the Minnesota Medical Group Management Association launched the online credentialing system in 2009 in response to a need to reduce the administrative burden and cost of credentialing. Currently, hospitals require credentialing updates every two years; health plans operate on a three-year cycle.
The new credentialing process allows physicians and other providers who are paid by Minnesota health plans or who need practicing privileges at a local hospital to subscribe to and submit credentialing updates through the MCC’s web-based information clearinghouse. Once an account is established, practitioners or practice managers can log on to the MCC website (www.MNCred.org) and input or upload data into the system. Only information that changes will need to be updated in the future. A subscription costs $25 a year per practitioner.
The online credentialing system replaces a cumbersome process by which physicians had to complete a paper application for each organization at which they wished to be credentialed. Illegible entries, missing information, and errors caused up to 50 percent of initial applications to be returned, forcing practitioners to start the process over. Credentialing could take 90 days or longer.
Using the new process, an applicant can complete the online form within 90 minutes. Once completed, subsequent applications and recredentialing requests can be sent to any number of organizations within minutes. As a result, credentialing takes substantially less time.
A Collaborative Approach
George Lohmer, the MMA’s chief financial officer and secretary-treasurer for the collaborative, said the impetus to streamline credentialing began more than 10 years ago. Four years ago, the MMA’s House of Delegates identified credentialing as members’ third most urgent challenge and their greatest challenge in terms of nonfinancial issues.
Three sponsoring groups—the MMA, the Minnesota Hospital Association, and the Minnesota Council of Health Plans—came together in mid-2008 to look for a way to simplify the credentialing process and established the MCC.
“Our goal was to make this easier for providers who can put their data in one secure place. What we did in the MCC is create a digital version of the paper form—we’re the TurboTax of credentialing,” says Richard Kreyer, the hospital association’s vice president and MCC chair elect. Typed information assures legibility, and the digital form directs applicants to any blank fields before it is submitted, Kreyer says.
MCC Chairperson Janny Brust, who represents the Minnesota Council of Health Plans, believes adoption of the electronic system will continue to grow among physicians and other clinicians; the MCC is currently working to increase hospital enrollment. “It will be the way we do business,” Brust says.
MCC Board Member Darla Morris-Preble, who represents the Minnesota Medical Group Management Association, notes that the new process has helped make credentialing more efficient and effective, and that physicians appreciate signing fewer papers. “As we move toward a paperless world, processing time will certainly be reduced,” she says.
Payers Bolster Effort
The credentialing effort received a boost in May, when the Minnesota Department of Human Services (DHS) agreed to use the MCC. The DHS tracks the credentials of providers who submit and receive payment for services provided to Minnesota health care program enrollees. The DHS plans to have an interface between their system and the MCC up and running later this summer.
“We like the MCC’s emphasis on convenience for providers, and we also like the potential for administrative savings for providers and payers alike,” says Billi Jo Zielinski, DHS assistant commissioner for health care.
In addition, PreferredOne Community Health Plan announced that beginning September 2010, all initial credentialing applications it receives will need to be submitted through the MCC. All recredentials will be done through the MCC starting in 2011.
“The electronic applications are more complete, accurate, quicker, and an overall better use of administrative resources for practitioners and PreferredOne alike,” says John Frederick, M.D., PreferredOne’s vice president and chief medical officer.—Michael Border
MMA Represented at AMA Annual Meeting
MMA members serving as delegates and alternate delegates to the American Medical Association (AMA) attended the AMA Annual Meeting June 12-16 in Chicago.
Delegates from around the country gathered to set AMA policy on issues affecting physicians and elect new leaders and council members. Much of the discussion centered around the recently enacted federal health care reform law. As a partial response to some of the concerns expressed about the new law, the AMA voted to immediately formulate legislation for a new Medicare payment option that would allow patients and physicians to privately contract for payments that differ from the Medicare schedule while still using Medicare benefits.
The AMA has supported the practice—known as balance billing—for a number of years, but passage of the resolution marks the first time the House of Delegates has asked the organization to push for a new law that would allow for both private contracting and balance billing.
“The new Medicare payment option advocated by the AMA would allow patients and physicians to contract for payments that differ from the Medicare schedule while allowing patients to use their Medicare benefits,” says MMA President Benjamin Whitten, M.D. “Without this type of flexibility, a large segment of the population will be in danger of losing timely access to quality health care.”
Blanton Bessinger, M.D., a pediatric cardiologist from St. Paul, was re-elected to the AMA Council on Constitution and Bylaws at the meeting. John Van Etta, M.D., an internist from Duluth, was not successful in his bid for election to the AMA Board of Trustees but was praised for his innovative campaign. Because he was recovering from surgery and therefore unable to attend the meeting, Van Etta campaigned virtually via a Skype video chat.
Maya Babu, M.D., a neurosurgery resident at Mayo Clinic who attended the AMA meeting for the first time, explained why Minnesota physicians should get involved in AMA policymaking. “It is very important for Minnesota physicians to remain vocal about the day-to-day challenges they face in caring for their patients. It is a perspective lawmakers don’t hear enough of. What lawmakers tend to hear are the lobbyists representing insurers, hospitals, and pharmaceutical and device makers,” she says. “If Minnesota physicians don’t speak up now, I’m afraid more and more physicians will be driven out of practice—and all of us will suffer if we can’t access the health care we need.”
View more photos of the Minnesota delegation at the 2010 AMA Annual Meeting at facebook.com/mnmed.
Free Colon Cancer Video Available
St. Paul-based Emergency and Community Health Outreach (ECHO) is making its 20-minute video “Understanding Colon Cancer” available to MMA members free of charge. The presentation is available in English, Somali, Spanish, Lao, and Hmong.
Colon cancer kills nearly 50,000 Americans every year, but colon and rectal cancer can be prevented or controlled if the disease is discovered early. The video presents information to help people from different cultural backgrounds understand this deadly-but-treatable cancer and the importance of screening.
The English version can be downloaded from the ECHO website; the video is available on DVD in all five languages. The organization welcomes donations to help cover the cost of production and distribution. To order a copy or make a donation, go to the ECHO website, www.echominnesota.org.
MMA Counsel Paints Mural for Gillette
The walls of Gillette Children’s Specialty Healthcare in St. Paul are a lot more colorful thanks to the work of Karolyn Stirewalt, MMA policy counsel. Stirewalt painted and donated a 16-foot-long mural to the facility, which is currently undergoing a multi-year expansion.
The mural, which is made out of four 4-by-7-foot wooden boards, is currently located at the entrance from the parking garage and will move to various sites within the building as construction continues.
“The mural is a vibrant celebration of our growth,” says Amy-Ann Mayberg, a project manager for the expansion at Gillette.
The acrylic painting, which took 12 weeks to complete, features a parade of people on a path from the existing Gillette building to the new facility. The characters depicted are actual hospital staff members, volunteers, and even service dogs that Gillette patients would recognize. In the mural, the hospital is surrounded by local attractions as well as the buildings of corporate contributors. Stirewalt says she included lots of details in hope that “patients will see the patients in the mural and be able to identify with them … to see themselves.”
The mural also includes kid-friendly embellishments. The adults depicted have name tags, the water in the fountain was done with glitter paint, and the hospital windows and the moon and stars in the sky glow in the dark.
“I did this to give young patients the impression that the lights are always on at Gillette, and that it is a safe place for them to be—even at nighttime,” Stirewalt says.
Stirewalt is also painting tables for the hospital’s new coffee shop. The tables, too, will be kid-friendly, with a “find the hidden objects” theme.—Ashley Cassidy