UR Medical Faculty Group Earns Reaccreditation

Perfect Score Earned on Stringent Credentialing Process

April 01, 2008

"Achieving NCQA certification for credentialing and recredentialing processes means that we are rigorously reviewing the backgrounds of each physician – from medical school graduation to the present – before we are granting membership to our organization."

The National Committee for Quality Assurance (NCQA) recently gave the University of Rochester Medical Faculty Group (URMFG) a perfect score for its credentialing and privileging systems, and recertified it as a Physician Organization. The NCQA seal is a widely recognized symbol of quality, and URMFG is one of only two physician credentialing organizations in upstate New York certified by NCQA.

URMFG, an organization of 982 physicians, is a division of the University of Rochester. Through its Medical Staff Office, URMFG serves as a central resource for credentialing physicians, coordinating privileges for all health care professionals working within the Medical Center, and negotiating payment rates with third-party payers. Seventeen payers delegate credentialing to URMFG.

According to Karen Crotinger, director of the Medical Center’s Medical Staff Office, the bi-annual recertification ensures the Medical Center is meeting or exceeding high national standards in credentialing physicians.

“Achieving NCQA certification for credentialing and recredentialing processes reassures the public and the insurance plans who contract with us that we are rigorously reviewing the backgrounds of each physician – from medical school graduation to the present – before we are granting membership to our organization,” Crotinger said. “This ensures that only the most highly qualified physicians practice as part of our group.”

The Medical Staff Office’s perfect score from the NCQA is in part a reflection of new electronic processes introduced over the past 18 months. By amassing all documentation in electronic format, the group can now provide physician information to staff through a convenient and secure electronic portal.

Barbara Bailey, audit specialist in the Medical Staff Office, helped to oversee the electronic conversion, and notes the new system has streamlined what was once a very cumbersome and time-intensive process. In any given year, the Medical Staff Office credentials more than 300 health care professionals, and recredentials another 1,500. It also coordinates paperwork to expand or renew more than 1,500 privileges for health care professionals each year.

“We are now able to do more work on a more timely basis with the same number of staff we had when we began our electronic conversion,” Bailey said. “And, we are saving an incredible amount of file space and paper. Notebooks with privileging information that used to literally take up four feet of cabinet space can now be accessed through our secure site.”

The National Committee for Quality Assurance is an independent, non-profit organization that certifies physician organizations, and accredits managed care organizations and preferred provider organizations. NCQA’s accreditation program represents the most rigorous standards of their kind. This is the second recertification URMFG has received since 2004; a follow-up audit is currently scheduled for April of 2010.

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Germaine Reinhardt
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