The “Introduction to Health Care” textbook (Mitchell & Haroun, p. 502-503) outlines that managed care plans are designed to increase efficiency, cut costs, provide affordable healthcare, ensure quality care, and eliminate waste. In my 20-plus years of reviewing healthcare payer agreements, I have learned to successfully decipher terms and conditions, as well as negotiate on
The Client: PeaceHealth Based in Vancouver, Wash., PeaceHealth is a health system serving patients in the Pacific Northwest and Alaska. More than 16,000 caregivers work at ten medical centers and care for patients in urban and rural communities. The Challenge PeaceHealth’s Medical Staff Services Department faced several challenges. Because the department’s had manual processes and
One of my favorite sayings is, “Change is chance.” I have used this mantra in coaching my team through transitions in new software, adapting to new processes, and moving into new offices. Personally, I am in the camp who loves change - most of the time. There are times, though, when change seems less like
Carole is inducted into the NAMSS Hall of Fame There’s a reason that Carole LaPine, MSA, CPMSM®, CPCS®, was one of the first two MSPs inducted into the NAMSS Hall of Fame. Actually, there are several reasons, all revolving around LaPine’s relentless commitment to excellence. The accolade she received in 2016 was the
Finding the optimal work-life balance is difficult – even for physicians. Like the rest of us, physicians are human beings with stress, emotions, and life situations that affect their behavior. Over the last several years, physician burnout rates have been a hot topic, and in the past year the world added a pandemic to the
Medical Service Professionals often have Type A personalities. We’re highly organized and proactive – and at times impatient and a bit anxious. It’s understandable that the possibility of losing control over our credentialing process can trigger negative reactions. After all, each hospital and health plan has its own application, its own credentialing process, and its
Team Med Global has unveiled the first-of-its-kind Executive Provider Enrollment Professional Competency Model. According to Team Med Global President Donna Goestenkors, CPMSM®, EMSP, the model reflects the skill sets required of payer enrollment specialists who are at the top of their field. “Executive Provider Enrollment Professionals exhibit the expertise, effectiveness, and impact that deliver value
Whether you’re looking for a quick huddle, a new position, or a way to share your expertise, The TMG Zone is the place to be. Join the TMG Zone on Facebook to connect with MSPs, payer enrollment specialists, practice managers, credentialing specialists, and others who are the gatekeepers of patient safety and revenue. “We designed
In January 2021, Donna Goestenkors commemorated her forty-fifth anniversary as a Medical Services Professional. Like so many of her colleagues, the door that would lead to Goestenkors’ lifetime of professional service opened unexpectedly. “When I graduated from business college, I applied to all of the hospitals in the St. Louis area,” she recalled. Christian Hospital
With 2020 behind us and the world still topsy-turvy from the pandemic, I still find my thoughts turning to, “What did I do in 2020?” If I am wondering that, my supervisor might be thinking something similar: What did the Medical Staff Department accomplish in 2020? An annual report answers this question. Requiring a thoughtful
You asked and Team Med Global delivered! Team Med Global is thrilled to launch the TMG University Accreditation Wizard. The 30 elements contained in the Wizard cover virtually every standard of credentialing as developed by eight different regulatory bodies and accreditation agencies: CMS, TJC, HFAP, DNV GL, CMS Managed Care, NCQA, URAC, and AAAHC. Team
It may seem counterintuitive, but a medical staff services consultant can stretch tight organizational budgets by creating value frameworks that deliver robust ROI. Whether your organization is looking to gain a fresh perspective, implement new programs and processes, or tap into a specialized skill set, a consultant can deliver. Below is an infographic that outlines
Team Med Global knows that MSP professional development is key to peak performance. Yet when discussing continuing education with our MSP colleagues, a common refrain is that they feel unsupported by leadership. It can be difficult to confidently make the case that leadership should invest in MSPs' continuing education. That’s why TMG has developed an
Payer enrollment is the cog that kicks off the revenue cycle. While most revenue cycle graphics indicate that client intake is the first stage in the cycle, the reality is that enrollment is the critical first phase. Payer enrollment is the process of enrolling organizations and providers into payer networks. The process varies by payer,
My work as a healthcare consultant often involves collaborating with organizations to streamline processes, implement technological solutions, and reconfigure accountability structures to create efficiencies. In other words, I help organizations do more with less. In 2020, however, “doing more with less” has taken on new meaning. This year’s COVID pandemic is the black swan event
