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ina Healthcare decreases turnaround time for credentialing by 44% while doubling number of applications processed per month
ECM
Much has been made lately of the benefits that can accrue to healthcare providers through the use of electronic medical records. In fact, one of the major long-term goals of the American Recovery and Reinvestment Act of 2009 (ARRA) is to initiate a process to computerize health records. In fact, one of the major long-term goals of the American Recovery and Reinvestment Act of 2009 (ARRA) is to initiate a process to computerize health records to reduce medical errors and save on health care costs.
But medical records are only one area in which providers can reap the benefits of working with secure, digital files. For organizations such as Molina Healthcare, a managed care organization (MCO) serving low-income individuals who frequently depend on government assistance, implementing a Laserfiche enterprise content management (ECM) system to digitize and streamline the healthcare provider credentialing process has proven to be extremely valuable.
The Importance of Credentialing
Credentialing is integral to the success of any healthcare organization, but it is a particularly important process for an MCO like Molina Healthcare. Effective credentialing helps MCOs manage liability risk, attract customers and obtain accreditation from organizations such as The Joint Commission and NCQA. It is also a procedural requirement by federal agencies such as CMS and various state agencies.
Molina Healthcare, a Fortune 1000 company that operates in nine statesCalifornia, Florida, Ohio, Michigan, Missouri, New Mexico, Texas, Utah and Washingtonhandles more than fifteen thousand provider applications a year. Legally, a healthcare practitioner cannot participate in Molinas network until the credentialing process is completed and a determination has been made to approve that provider for participation.
Every day a provider remains in the credentialing process, says Ryan Boe, corporate credentialing manager at Molina Healthcare, is another day that he or she cant provide care for our members.
According to Boe, applications frequently consist of 30-100 pages of material [link widoczny dla zalogowanych], including a physicians state license, board certification, criminal history report, stated work history, educational background, malpractice history and more. Dealing with paper, he says, is much slower than working with electronic records.
Paper Process
In the past [link widoczny dla zalogowanych], Molinas credentialing department produced a single paper copy of each application and routed it to different people during the credentialing process. According to Michael Eisenman, healthcare analyst for the credentialing department, coordinating the logistics and timing for moving applications through various steps of the process was difficult.
When youre reviewing hundreds of applications a month, its not practical to physically transfer them one-by-one, he says. But transporting hardcopy files in batches leads to processing bottlenecks, which slows everything down.
From a cost standpoint, printing paper applications consumed reams and reams of paper, and the special couriers who shipped credentialing files between offices were an additional expense. Additionally [link widoczny dla zalogowanych], the physical space needed to store and retain the documentation (including a great number of wall racks) led to extra cost.
Working with paper also brings up liability issues for MCOs like Molina: HIPAA mandates that we keep medical information secure, but its hard to do that with paper files, Eisenman explains. Paper isnt password-protected, and it doesnt produce an audit trail.
Implementing Enterprise Content Management
Tasked with finding the best way to digitize credentialing applications and automate key pieces of the credentialing process, an IT committee chose a Laserfiche Rio ECM system due to its rich scanning, workflow, secu