Physician Re-Credentialing with Salesforce Health Cloud

The Problem

Physician re-credentialing might sound as simple as checking boxes...but anyone in healthcare knows it's not so simple. Below, we've created a list of what most hospitals are up against. Do any of these sound like you?

Scattered Documentation

• Scattered Records
  Key documents—state licenses, board certifications, and more—are saved in multiple, disconnected systems.
• Unstructured, Outdated Files
  Physicians' credentials often take the form of unsearchable PDFs, photos, scans, or mismatched formats without any version control.

Manual Notification

• Manually Sent Reminders
  Teams send credentialing reminders sporadically. Timing depends entirely on already busy credentialing specialists, leaving room for errors and oversight.
• Single-Channel Dependence
  Notifications typically rely on email alone, making it easy for messages to get buried.

Process Painpoints

• Time-consuming Tasks
  The re-credentialing process asks a lot of physicians and staff alike. Forms, resubmissions, and manual checks cause delays, frustration, and non-compliance.
• Lack of Ownership
  Tasks aren't clearly assigned, preventing staff from attacking their daily workload efficiently.
• Error-Prone Manual Systems
  Manual tasks fill workflows with errors and gaps, from out-of-date documents to prolonged approvals.

Data Black Hole

• No Dashboard Visibility
  Staff don't have a unified view of expiring credentials.
• Leadership in the Dark
  Without analytics, leadership can't identify bottlenecks in the process.

The Solution

Salesforce Health Cloud provides a re-credentialing framework for storing credentialing documentation, triggering notifications, and automating consistent workflows. A framework lowers the amount of manual work involved, which can eliminate gaps in a physician's billable status and improve compliance. Here's what it looks like.

Centralized Documentation

Health Cloud stores all credentialing data for each physician, including state licenses, work history, and liability coverage. Credentialing specialists no longer have to search for credentials - everything related to a physician is at their fingertips on one central record. Relevant information, including license numbers and expiration dates, has been extracted with Mulesoft Intelligent Document Processing from images, PDFs, and photos. Every detail needed for thorough verification is structured and searchable for credentialing staff.

Automated Notifications

Automated workflows trigger communications at set intervals. For instance, Health Cloud workflows remind physicians to re-submit documentation for certification 30 days, 60 days, or 90 days before expiration. Health Cloud triggers reminders without manual intervention based on expiration dates scraped from unstructured documents.

Health Cloud sends alerts over multiple channels, including email, text, or Salesforce Mobile push. We create attention over various channels, making messages less likely to be missed. Escalation workflows can bring inaction to a supervisor's attention as an additional safeguard.

Smarter Processes

Salesforce Flows can pre-fill applications with standard physician information. Pre-fill quickens the application process and reduces errors when manually entering information. Salesforce Experience Cloud portals can enhance this experience, as the authenticated experience improves data security.

Salesforce Health Cloud's case management features assign re-credentialing tasks with deadlines. Task assignments help staff understand their responsibilities and keep track of their work, helping them complete re-certifications on time. 

Salesforce Health Cloud also integrates with major primary sources for automatic verification. Credentialing specialists no longer have to access credentialing authorities to compare physician applications with primary sources – everything is available in one platform, and verification is automated.

Better Data Dashboards

As we covered before, Health Cloud stores documentation in structured data and tracks all credentialing tasks. Central access means credentialing specialists can quickly view upcoming overdue renewals and credentials, giving them the information they need to plan their day. 

Additionally, credentialing leadership gains insight into data that helps them analyze how efficient the credentialing process is. For instance, they can understand average processing time, non-billable physicians, and where manual tasks are slowing credentialing. 

The Results

It doesn't take long for most hospitals to see measurable improvements in their re-credentialing process.

More Billable Physicians

Hospitals eliminate credentialing gaps and ensure that more physicians remain compliant and billable.

Faster Processes

Thanks to automation and improved workflows, re-credentialing happens faster. Credentialing specialists can now complete time-consuming tasks with a few clicks.

Reduced Manual Work

Health Cloud drastically reduces the time spent on redundant manual work by unifying data and automating repeatable processes.

Fewer Errors

Automated reminders driven by structured data lessen human errors, ensuring error-free re-credentialing.

Also, consider the intangible benefits like a less stressed credentialing team, more collaboration, and a data-driven leadership team.

Conclusion

Today, hospitals are ending chaotic re-credentialing processes with Salesforce Health Cloud. Are you looking for a way to end manual processes, unbillable physicians, and error-prone verifications? See what Salesforce Health Cloud could do for you.