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States seek to streamline credentials verification process

Minnesota health care stakeholders have found ways to save time and reduce duplication of paperwork through creation of a "one-stop" database.

By Andis Robeznieks, amednews staff. Nov. 12, 2001.

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For physicians all across the country, getting their credentials into the hands of hospital and health plan officials requires a tedious ritual of repetitive form completion.

Doctors in Minnesota, however, have found a better way. They created a centralized, statewide database of verified credentials information readily available to the hospitals and health plans that need it.

According to a 1998 survey by the Minnesota Medical Assn., the typical Minnesota physician has privileges at three hospitals and participates in five health plans, each requiring verification of that doctor's credentials about every two years.

Physicians complained to MMA officials and asked if something could be done to eliminate the duplication involved in the credentialing process, said association representative Lorrie Holmgren.

"Our members asked: 'Isn't there a way to simplify this? Couldn't we just fill out one form?' " Holmgren said.

Doctors weren't the only ones who had a problem with this process. Hospitals and health plans also had to collect, verify, update and store the information doctors supplied.

Although all sides agreed something needed to be done, they had to jump through some legal hoops before they could get the effort started.

"Competing health plans and physicians could not sit at the same table," said Benjamin Whitten, MD, who chaired the MMA credentialing reform task force. Dr. Whitten, a Minneapolis internist, explained that a separate, limited liability corporation needed to be established so the parties involved would not violate antitrust laws. [...]