JENNIFER LINCOLN, CPLS’ Post

AVOID 8 COMMON PHYSICIAN CREDENTIALING PITFALLS 1. Relying on limited staff and administration: Credentialing includes verifying a clinician's education, medical training, residency, licenses, and certifications issued by a board in the physician's area of specialty. 2. Incomplete physician enrollment applications: The average physician enrollment application requires a vast amount of information and data. Failing to accurately fill out the application in its entirety causes delays in reimbursement and denial of claims. 3. Allowing physicians to treat patients before credentialing is completed: Courts have ruled that hospitals can be held liable when a physician falsifies credentials or begins practicing before credentialing has been completed. 4. Not updating and verifying information: Physicians need to renew their licenses and credentials on a regular basis, according to the laws of the state in which they practice. Initial credentialing and recredentialing ensures that physicians are up to date with their board certifications and licenses. 5. Covering up prior adverse action: Failing to disclose an adverse action is a serious oversight by any physician, but it is also the responsibility of a healthcare organization to conduct screenings for prior disciplinary actions with a thorough background check. 6. Failing to report adverse actions: Physicians are required to report adverse actions such as license revocation; exclusion from third-party programs; and suspension or voluntary relinquishment of medical staff membership or clinical privileges. 7. Failing to report adverse actions to the National Practitioners Data Bank (NPDB): Physicians and healthcare organizations that fail to report adverse actions to the NPDB withhold critical information needed to complete medical credentialing. 8. Failing to take peer review activity seriously: Information provided in a peer review or investigation should be taken seriously and be evaluated as part of the credentialing process. Peer references can inform the capabilities and competencies of a physician that cannot be determined from simply checking education, training, or license status.

Navigating medical licensure in the U.S. can feel like a labyrinth, with each state setting its own rules and pace. Some states offer a swift and streamlined process, while others pose significant challenges that can extend timelines and complicate your practice plans👩⚕️ ✨ 𝘛𝘩𝘦 𝘌𝘢𝘴𝘪𝘦𝘴𝘵 𝘚𝘵𝘢𝘵𝘦𝘴 𝘵𝘰 𝘎𝘦𝘵 𝘔𝘦𝘥𝘪𝘤𝘢𝘭 𝘓𝘪𝘤𝘦𝘯𝘴𝘦 🔹𝐍𝐞𝐰 𝐘𝐨𝐫𝐤 Fast-track your license! No need for extensive verifications, with typical processing in just 6-12 weeks. 🔹𝐈𝐧𝐝𝐢𝐚𝐧𝐚 Only 10 weeks to a new license, with temporary permits available to speed things up even further! 🔹𝐌𝐢𝐜𝐡𝐢𝐠𝐚𝐧 Benefit from reciprocity if you’ve been licensed in another state or Canada within the last decade—get licensed in as little as 1.5 months. 🔹𝐂𝐨𝐥𝐨𝐫𝐚𝐝𝐨 Take advantage of the fast-track application, potentially getting you licensed within 30 days! 🔹𝐎𝐡𝐢𝐨 Offers a reciprocal licensure path for those with existing licenses from other states, simplifying your transition. 🤔 𝘊𝘶𝘳𝘪𝘰𝘶𝘴 𝘢𝘣𝘰𝘶𝘵 𝘸𝘩𝘪𝘤𝘩 𝘴𝘵𝘢𝘵𝘦𝘴 𝘢𝘳𝘦 𝘵𝘩𝘦 𝘵𝘰𝘶𝘨𝘩𝘦𝘴𝘵 𝘧𝘰𝘳 𝘴𝘦𝘤𝘶𝘳𝘪𝘯𝘨 𝘢 𝘮𝘦𝘥𝘪𝘤𝘢𝘭 𝘭𝘪𝘤𝘦𝘯𝘴𝘦? Some states have rigorous processes that can be daunting for applicants. From extensive documentation to long wait times, find out which states make medical licensing a real challenge and why. Get the insights you need to avoid pitfalls in our comprehensive guide 👉 https://lnkd.in/eZugsh83 🌐 𝐒𝐭𝐫𝐞𝐚𝐦𝐥𝐢𝐧𝐞 𝐘𝐨𝐮𝐫 𝐋𝐢𝐜𝐞𝐧𝐬𝐢𝐧𝐠 𝐰𝐢𝐭𝐡 𝐌𝐞𝐝𝐢𝐜𝐚𝐥𝐋𝐢𝐜𝐞𝐧𝐬𝐢𝐧𝐠.𝐜𝐨𝐦 Don’t let the complexities of medical licensure slow down your career progression. Our team handles the licensing process for all 50 states, freeing you to focus more on what you do best—caring for patients. 📞 𝐂𝐨𝐧𝐭𝐚𝐜𝐭 𝐮𝐬 𝐭𝐨𝐝𝐚𝐲 𝐟𝐨𝐫 𝐚 𝐟𝐫𝐞𝐞 𝐜𝐨𝐧𝐬𝐮𝐥𝐭𝐚𝐭𝐢𝐨𝐧 𝐚𝐧𝐝 𝐬𝐞𝐞 𝐡𝐨𝐰 𝐰𝐞 𝐜𝐚𝐧 𝐬𝐢𝐦𝐩𝐥𝐢𝐟𝐲 𝐲𝐨𝐮𝐫 𝐥𝐢𝐜𝐞𝐧𝐬𝐮𝐫𝐞 𝐩𝐫𝐨𝐜𝐞𝐬𝐬. #MedicalLicensing #Healthcare #Physicians #USMLE #MedicalCareer #HealthcareProfessionals #MedicalEducation #PhysicianLicensing #MedicalBoard #HealthcareIndustry

When Persistence Is Rewarded I am passionate about physician documentation, working with physicians hand in hand as a champion of better more effective quality documentation and communication of patient care. Currently, I am working with seventeen hospitalists in a group that has been staffing a medical center for the last four months. Part of my role is to provide a two-hour orientation on best practices of documentation, setting the expectation for physician documentation right up front. Then I establish a baseline for their documentation by reviewing the first two weeks of their charts using a scorecard for H & Ps, Progress Notes, and Discharge Summaries. The results of each reviewed chart are provided to the physician in a one-on-one training session. The cycle continues until the physician achieves a 95% score on the quality of documentation for each patient admission. What I have learned is the following: 1- Physicians truly want to achieve documentation excellence if you approach training from a physician perspective- How can adhering to better practices of documentation save the physician time and energy., allowing physicians to spend more time doctoring in front of the patient and less time doctoring in front of the computer 2- Physicians want training in better more efficient approaches to documentation. They do not want more queries, they prefer to document correctly the first time around. Physicians realize that queries for diagnoses are mere measures of documentation defects. What physicians desire a 30% rate of defects? Sometimes I must spend more time working with physicians to achieve a 95% score on their documentation. Today it felt so rewarding to issue this feedback to a particular physician: "Dr. X" Thank you for your excellent documentation on account X, the patient who went to Cacun and came back with an ulcer in his toe with cellulitis and leg edema with the malodorous smell from the ulcer. You not only told but also showed the need for a hospital level of care that requires at least two midnights. This is the standard of documentation! Thank you for your work and commitment to the patient with quality documentation that depicts and tells the patient's clinical story. The response from the physician: "Hi Glenn! Thank you for the kind words! And we all are grateful for all your work and your feedback!" Success stories such as this should inspire all CDI to be committed to supporting and advocating for change in current mandated CDI processes that produce the wrong results, that is capture of diagnoses that while important, but do not actually achieve much in the way of revenue integrity #CDI, #committment, #betterdocumentation, #setupgoals, #holisticCDI

The Advisory Commission on Additional Licensing Models has released draft preliminary recommendations for public comment through December 6. The recommendations were compiled in response to a growing number of U.S. state and territorial legislatures interested in modifying traditional post-graduate training requirements for medical licensure of physicians who have completed training internationally by eliminating the traditional requirement for completion of ACGME-accredited graduate medical education in the U.S.   State medical boards and other interested parties are encouraged to submit comments through December 6, 2024. Upon completion of the public comment period, the Advisory Commission will review the feedback and comments received and release its preliminary guidance for formal consideration in early 2025.   Once finalized, the recommendations are intended for state medical boards, state legislators, policymakers and interested stakeholders to help inform those jurisdictions interested in developing or modifying additional licensing pathways for physicians who have completed training internationally. The Advisory Commission was established in December 2023 by FSMB, Intealth, and the ACGME. Read the full draft guidance document and recommendations and provide your feedback --> https://bit.ly/47SFFo3

Staying up-to-date with medical certifications and industry trends is crucial for healthcare professionals to maintain a competitive edge. This insightful article by @Apaana highlights the key benefits of keeping your credentials current, such as compliance with regulations, career advancement opportunities, and delivering high-quality patient care. The article emphasizes the importance of regularly reviewing certification requirements, actively pursuing relevant medical certifications like CMC, CPhT, CMT, and staying informed about regulatory changes that impact credentialing. It also recommends networking with credentialing specialists who can provide valuable guidance on the latest trends and requirements specific to your field. At Manage You, we understand the challenges of keeping track of multiple certifications, licenses, and documentation. Our user-friendly app streamlines the entire process by providing a centralized platform to manage all your credentials, receive automated reminders for renewals, and ensure compliance with ever-evolving industry standards. Stay ahead of the curve and maintain your competitive edge with Manage You. Read the full article for more insights, and explore how our app can simplify your credentialing journey, allowing you to focus on delivering exceptional patient care. https://loom.ly/69p1R1I

Understanding the spectrum of medical licenses is crucial, as each type caters to specific roles and circumstances, directly influencing the services you can provide. Choosing incorrectly or misinterpreting a license’s scope can lead to severe consequences, requiring costly and time-consuming adjustments 🩺 Here's a glimpse into the nuanced world of medical licensing: 🔹𝐓𝐞𝐥𝐞𝐡𝐞𝐚𝐥𝐭𝐡 𝐋𝐢𝐜𝐞𝐧𝐬𝐞𝐬 To provide telehealth services some states provide dedicated licenses while others require healthcare practitioners to be licensed in the jurisdiction where their patients reside. 🔹𝐄𝐱𝐩𝐞𝐝𝐢𝐭𝐞𝐝 𝐋𝐢𝐜𝐞𝐧𝐬𝐞𝐬 States that offer expedited licensing processes typically streamline the verification of credentials and fast-track administrative procedures to reduce the waiting period. 🔹𝐋𝐢𝐜𝐞𝐧𝐬𝐮𝐫𝐞 𝐛𝐲 𝐄𝐧𝐝𝐨𝐫𝐬𝐞𝐦𝐞𝐧𝐭 Especially useful to expand practice beyond state boundaries. To be eligible, candidates must satisfy all licensing standards similar to those of the state to which they are seeking. 🔹𝐂𝐨𝐦𝐩𝐚𝐜𝐭 𝐋𝐢𝐜𝐞𝐧𝐬𝐞𝐬 Facilitate easier and quicker access to licensure and enhance the availability of medical services across the country, for various providers, from physicians to psychologists. 𝘍𝘳𝘰𝘮 𝘭𝘪𝘮𝘪𝘵𝘦𝘥 𝘱𝘳𝘢𝘤𝘵𝘪𝘤𝘦 𝘭𝘪𝘤𝘦𝘯𝘴𝘦𝘴 𝘪𝘯 𝘴𝘱𝘦𝘤𝘪𝘢𝘭𝘪𝘻𝘦𝘥 𝘴𝘦𝘵𝘵𝘪𝘯𝘨𝘴 𝘵𝘰 𝘭𝘰𝘤𝘶𝘮 𝘵𝘦𝘯𝘦𝘯𝘴 𝘭𝘪𝘤𝘦𝘯𝘴𝘦𝘴 𝘧𝘰𝘳 𝘵𝘦𝘮𝘱𝘰𝘳𝘢𝘳𝘺 𝘢𝘴𝘴𝘪𝘨𝘯𝘮𝘦𝘯𝘵𝘴, 𝘵𝘩𝘦 𝘭𝘢𝘯𝘥𝘴𝘤𝘢𝘱𝘦 𝘪𝘴 𝘢𝘴 𝘥𝘪𝘷𝘦𝘳𝘴𝘦 𝘢𝘴 𝘪𝘵 𝘪𝘴 𝘤𝘰𝘮𝘱𝘭𝘦𝘹. Dive deeper into the different medical licenses available and how they can shape your career 👉 https://lnkd.in/edd5uS3G #HealthcareLicensing #MedicalPractice #Telehealth #MedicalEducation #HealthcareProfessionals #MedicalLicenses #Physicians #Nurses #HealthcareRegulation #MedicalCare

💡 Why Doctors Need to Understand #RevenueCycleManagement (RCM) and #ClinicalDocumentationIntegrity 💡 When we think about medical education, our minds often go straight to #patientcare, #diagnostics, and #treatmentprotocols. But there’s another crucial aspect that’s sometimes overlooked – Revenue Cycle Management (RCM). 🏥💰 Why is RCM important for doctors? 1. 💼 Smooth Transition to Practice: As doctors transition from training to practice, understanding RCM is vital. It ensures that they can seamlessly integrate into healthcare systems, where financial viability is as critical as clinical excellence. 2. 📝 Clinical Documentation Integrity (CDI): Accurate and thorough clinical documentation is the backbone of RCM. CDI ensures that patient records are complete, accurate, and timely, which directly impacts reimbursement and compliance. Without proper documentation, hospitals risk financial penalties and reduced reimbursement rates. 3. 🔄 Comprehensive Patient Care: Effective RCM and CDI are not just about money; they’re about maintaining high standards of patient care. Proper documentation reflects the quality of care provided and supports continuity of care, making sure every healthcare professional involved has access to the complete patient history. 4. 📊 Data-Driven Decisions: CDI helps in gathering precise data, which is essential for decision-making and improving healthcare delivery. This data aids in understanding patient outcomes, managing resources, and enhancing overall healthcare quality. #Challenges & #Solutions Transitioning into practice with a sound understanding of RCM and CDI can be challenging but necessary. Here’s why this needs to be addressed: • 📚 #Education and #Training: Incorporating RCM and CDI into medical education ensures that future doctors are well-prepared to navigate the complex healthcare landscape. This knowledge helps them understand the financial aspects of healthcare, which is essential for both private practices and large healthcare institutions. • 🛠️ #ContinuousLearning: Healthcare is ever-evolving, and so is the RCM landscape. Continuous education on new regulations, coding standards, and documentation practices is crucial for maintaining financial health and compliance. • 🤝 #Collaboration: Encouraging collaboration between clinical and administrative staff fosters a holistic approach to healthcare. When doctors understand the importance of RCM, they can work more effectively with billing and coding teams to ensure accuracy and efficiency. In conclusion, RCM and CDI are essential to healthcare. Educating doctors on these ensures they excel clinically and navigate the healthcare system effectively, crucial for high-quality patient care and financial health. 🌟 #HealthcareManagement #ClinicalDocumentation #MedicalEducation #RevenueCycleManagement #HealthcareFinance #PatientCare #HealthcareInnovation

To Be a Great Physician, You Must Understand the Whole Story I posted this a while back and thought it prudent to post again given the successes Keith Stokes, MD, Jacob Martin, and I are having working with Open Source MD, Inc. hospitalists at their hospital client. Our approach to physician documentation improvement is to promote and advocate for complete and accurate physician documentation, making a compelling case to physicians that the medical record serves first and foremost as a communication tool versus a reimbursement tool as most CDI programs treat and see the medical record. Physicians must see the medical record as a tool to convey a patient story, a version of a short novel with an introduction, body, and ending. In this case, the story begins with the H & P, the body is the progress notes, and the discharge summary is the ending. A better approach to physician documentation education and training is to work with physicians as collaborators and facilitators of clear, concise, consistent, contextually correct, and organized physician documentation that adequately tells, describes, shows, and reflects the patient's true clinical story, need for hospital level of care, the establishment of medical necessity, shows the progress of the patient, and readiness for discharge. Physician's assessment with diagnoses accompanied by a congruent plan of care, supported by the clinical facts, clinical information, and clinical context as taught for physicians to document, will make for far better documentation that will stand the test of time, less prone to payer denials and costly financial takebacks. This process is what all CDI programs must subscribe to in the quest to refer to themselves as "clinical documentation integrity specialists." Reach out to me to learn more about how best to revamp, rebrand, and reengineer your CDI program for optimal success Sir William Osler said, “The good physician treats the disease; the great physician treats the patient who has the disease.” The great physician understands the patient and the context of that patient's illness. I submit to all that a great physician can effectively understand and document the entire patient story. CDI can be instrumental in helping physicians master the telling and documenting of the patient's story. #CDIfacilitator, #CDIhelpingphysicians, #masterdocumentation, Cesar M. Limjoco, M.D., Keith Stokes, MD, #cdirebranding https://lnkd.in/ezGiNmBh.

Growing in the Healthcare World: A Journey of Professional Development. In the ever-evolving landscape of healthcare, personal and professional growth is not merely a journey; it is a commitment to excellence, compassion, and continuous learning. From healthcare providers to administrators, researchers to policymakers, individuals navigate through challenges and opportunities, driven by a shared mission: to improve the quality of life and well-being of individuals and communities. Herein lies the narrative of growth in the healthcare world, a narrative shaped by dedication, innovation, and collaboration. At its core, growth in the healthcare realm is deeply intertwined with knowledge acquisition and skill development. For healthcare professionals, the journey begins with foundational education and clinical training. Whether pursuing a career as a physician, nurse, pharmacist, or allied health professional, the pursuit of excellence demands a rigorous academic curriculum coupled with hands-on clinical experience. From mastering anatomy and physiology to refining diagnostic skills and therapeutic interventions, the journey is one of continuous refinement and mastery. Beyond the confines of traditional education, healthcare professionals embark on a lifelong journey of learning and adaptation. In an era characterized by rapid advancements in medical science and technology, staying abreast of emerging trends and evidence-based practices is paramount. Continuous medical education (CME) programs, conferences, and workshops serve as invaluable platforms for knowledge exchange, fostering interdisciplinary collaboration and innovation. However, growth in healthcare transcends the confines of technical proficiency; it is imbued with a profound sense of empathy, compassion, and human connection. As healthcare providers, individuals bear witness to the joys and sorrows, triumphs, and tragedies of the human experience. In the face of adversity and uncertainty, they serve as beacons of hope and healing, offering solace and support to those in need. Empathy, therefore, becomes not only a skill but a cornerstone of compassionate care, fostering trust, understanding, and therapeutic rapport between patients and providers. In conclusion, growth in the healthcare world is a multifaceted journey marked by perseverance, passion, and purpose. It is a journey of intellectual curiosity and technical mastery, fueled by a commitment to lifelong learning and innovation. It is a journey of leadership and advocacy, where individuals leverage their expertise and influence to effect positive change in the lives of others. Ultimately, in the tapestry of healthcare, growth is not merely an aspiration; it is a testament to the enduring spirit of resilience, collaboration, and compassion that defines the essence of healing and humanity.