Credentialing for Ambulatory Surgery Centers - What You Need to Know

This blog post is an excerpt from an article published first on Becker's ASC review, written by Laura Dydra.

Physician recruitment is one of the key growth strategies for Ambulatory Surgery Centers (ASCs). Surgery centers can either attract physicians to bring cases or new physician investors to boost case volume, and add specialties. Here are a few things to know when credentialing new physicians for your surgery center.

Joint Commission Requirements

The Joint Commission released a tool for surgery centers covering physician credentialing and accreditation updates, here are the major actions to take to ensure your patients are receiving quality care from qualified providers:

• Define the scope of care within your organization
• Identify licensed providers and make sure they are practicing within state laws and regulations
• Determine the scope of practice for each provider type
• Define qualifications for licensed providers to be privileged to practice at your facility, including education, training, and board certification
• Require each provider to formally request privileges for the specific care or treatment they perform
• Verify credentialing information such as current license, sanctions, DEA certification, etc.

Eight Tips for an Efficient Credentialing Process

• Assign someone at the ASC to keep track of credentialing every clinician at the center. This person can update credentials and license information when necessary and take new physicians through the credentialing process.
• It takes on average 60 to 90 days for surgery centers to collect all credentialing material required. ASCs can grant temporary permission for surgeons to perform cases without all credentials in place, but it's prudent to conduct a background check on surgeons first to establish they don't have a higher number of adverse events that could put the center at risk.
• There are several forms physicians and their offices must fill out to obtain credentials at the ASC. Stress the importance of filling the forms out fully before returning them to the ASC; otherwise, there will be more back-and-forth between the physician's office and ASC, adding time to the process.
• Keep credentials up-to-date to avoid medico-legal issues. If malpractice occurs and the physician's credentials are outdated, the ASC could run into legal issues.
• Keep a calendar of the important licensure updates and credentialing dates to track updates throughout the year. There are automated systems available to help with this process and notify administrators 30 days before a physician's license, board certification, certificate of insurance and more expires to allow ample time for renewal.
• Each state has different requirements for physician credentials, but many follow similar rules to accrediting bodies. Make sure you know the rules for your state and accrediting body so you're prepared when the surveyor arrives.
• Regularly audit files to ensure there aren't omissions in a physician's credentials. Staff members may initially overlook a mistake or forget to update credentials.

Credentialing Mistakes to Avoid

Here are 10 common credentialing mistakes for surgery centers to avoid:

1. Not having an appropriate employee who is skilled and knowledgeable in the credentialing role.
2. Not having a predefined process for application requests.
3. Not having intuitive and user-friendly credentialing software.
4. Not updating clinical privilege forms.
5. Not having completed files before committee action.
6. Not following regulatory and accreditation standards.
7. Not following the facility's governance documents.
8. Not linking quality to appointment of physicians.
9. Not understanding the approval process. 
10. Not engaging everyone in credentialing.

Make sure your Ambulatory Surgery Center continues to grow and prosper. Contact us today for a free consultation on your credentialing process.