Privileging Telehealth Providers

Privileging Telehealth Providers

May 28, 2019
  • Author:
    Vicki Searcy
    Former VP, Consulting
    Vicki has managed several credentialing and privileging practices, led a national healthcare accreditation and compliance consulting practice, was a surveyor for the NCQA, and a former president of NAMSS.

I had a discussion earlier this week with one of the consultants on our team. The discussion focused on how she got into credentialing, how she transitioned into working for a software vendor and her career pathway into the consulting team at VerityStream. There has been a theme among our consulting team – they love the fact that industry needs are constantly changing, which creates the need to constantly expand their knowledge. Every week, month and year there are opportunities to learn. As I think back upon my career, what I’m doing today as a consultant is markedly different than what I did 5 years, 10 years or 20 years ago. Today I work with clients on issues that were not even part of the industry 5 or 10 years ago.

One of those issues in today’s credentialing industry is the significant upswing in the use of telehealth providers throughout healthcare (you may call this telemedicine, eHealth, etc.). You may be in an organization that provides telehealth services to other organizations and/or receives telehealth services. It is a rare organization these days that is not involved in telehealth services. And it is only going to grow!

The thing that we all have in common from a credentialing and privileging perspective is how to manage the credentialing and privileging of these providers and determining what data is needed in our provider/credentialing database in order to manage and produce the reports that are needed.

It is evident to me from speaking with credentialing professionals from organizations all over the country that credentialing via proxy (which has been permitted by CMS since July 5, 2011) is not being used as widely as it could be – and when it has been implemented, there are still lots of requests for provider credentialing data from the originating site to the distant site that is not required under CMS and Joint Commission requirements (originating site is where the patient is – distant site is where the provider is credentialed). There are lots of variations in the way that organizations handle telehealth providers. That is typical when new components are added to credentialing/privileging – it takes some time for the industry to develop a defined roadmap that most organizations utilize. Remember when FPPE was introduced by the Joint Commission in 2008? It has taken some time for organizations to adopt what we might call best practices in how to implement and manage FPPE.

Todd Sagin, MD, JD and I will be speaking on the topic of telemedicine at the NAMSS Conference on October 22, 2019 in Philadelphia, PA. We heard from you before the conference about the issues you are dealing with as you manage your telehealth providers. Check out our blog post on the results of the survey about how organizations are involved in credentialing telehealth providers.

Thanks for listening – and thanks for your help as we delve into issues related to streamlining how we manage our telehealth providers.