Cooperation on physician credentialing. (Short Takes).Humana Inc., Oxford Health Plans, Inc.. and UnitedHealthcare have announced that they intend to use a single application process to credential credential verb To determine or verify titles, qualifications, documents, completion of required training, and continuing education, in those persons who function in a professional or official capacity–eg, ER physician, neurosurgeon, etc. Cf Credentials. potential medical providers for their networks. Doctors and other health professionals looking to become part of any of the three companies' networks will have to fill out just one universal application for network and credentialing activities. Such cooperation among health care competitors is unprecedented, but Humana's Chief Medical Officer, Jerry Reeves, MD, believes it makes good sense. "Everyone wins with this type of arrangement," he says." Doctors with less paperwork can deliver more personalized per·son·al·ize tr.v. per·son·al·ized, per·son·al·iz·ing, per·son·al·iz·es 1. To take (a general remark or characterization) in a personal manner. 2. To attribute human or personal qualities to; personify. care to patients, and a single process means greater efficiency for health plans." Humana, Oxford, and UnitedHealthcare can take this step because they all use the same company for screening providers--Aperture, a Louisville. Kentucky-based company that is fully certified See certification. by the National Committee for Quality Assurance National Committee for Quality Assurance Medical practice A private, not-for-profit organization which has become the leading accreditor of managed care plans; in site visits, NCQA reviewers evaluate a managed care plan in terms of quality management, physicians' (NCQA NCQA National Committee on Quality Assurance, see there ).The three companies say they aren't giving up the judgment that is essential for creating the provider networks their clients need and want. The only thing being shared is application information about providers. Cooperating on the collection of physician information is expected to reduce operating costs operating costs npl → gastos mpl operacionales for both physicians and health plans. Other companies are free to join the joint credentialing venture if they wish. --James A. Hawkins is Publisher of Healthcare Briefings, a newsletter available in print, on cassette, via fax, and on computer disk. He can be reached at 800/338-5486. |
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