A Day In The Life of a Credentialing Expert

Iris Telehealth recruits and hires top notch clinicians and finds them placement in our partner facilities across the country, a process we call “matching.” Unlike many staffing agencies and locum tenens groups, these matches are meant to be as permanent as a typical onsite provider’s position would be. Providers are our employees and treated as independent contractors by the facility they are matched with. However, Iris is unique because we are advocates for both our providers and our partner facilities. This enterprise doesn’t work properly without both sides of the equation. By operating this way, we provide the best maximum outreach and positive community impact as possible.

The Clinical Operations Department at Iris is the intermediary between our clinicians and our clinics/hospitals. They act as the engine that implements matches, making it possible for services to be provided. Within Clinical Operations, we have Clinical Operations Managers as well as the Licensing and Credentialing team. Each match will have one Clinical Operations Manager and one Licensing and Credentialing Coordinator working on that implementation with the clinician and the partner facility.

I spent thirteen months on the Licensing and Credentialing team. Although I am currently transitioning to a different role within operations, I can attest to the fact that they are essentially efficiency machines. A typical day of my life in this role went a little something like this...

7:45 AM - 8:15 AM: This is when I would typically roll into the office, cold brew in hand. (That applies all year round, which I consider a benefit of living in Austin, Texas. No hot coffee for me, thanks!)

8:15 AM - 8:45 AM: As the detail-oriented person that I am, I spent this chunk of my morning looking through calendars and emails to ensure I knew what was going on around me and how I was going to spend my workday. I would get several requests from credentialing staff that were also going through their inbox, and I would jot them down on my list of tasks for the day. We work out of a credentialing database called Council for Affordable Quality Healthcare (CAQH) where providers fill out their profile and insurance companies use that to verify their credentials. As usual, several CAQH profile updates needed to be made, a few insurance enrollment related forms needed to have doctors sign, etc.

8:45 AM – 9:00 AM: Credentialing Huddle! Every morning, our team would meet to discuss whatever the day’s topic was. On Mondays, we would discuss the week’s upcoming implementations and any foreseeable issues. Tuesdays were for discussing everyone’s individual goals for the day. Wednesdays were the outpatient huddle, where the Clinical Operations Managers joined us so we could give one another updates on each outpatient implementation in progress. Thursdays were Thoughtful Thursday, and we would each talk about something that was on our mind and influential in our work. Fridays were the weekly review with the entire Clinical Operations team where we would award informal kudos and talk about our wins that week. Today is Tuesday, and I let the team know I’ll be working on a Kansas medical license application, a few credentialing applications for my newest implementation, and spending the rest of the day doing license renewals.

9:00 AM – 10:00 AM: A new provider who made it through the majority of the hiring process submitted their credentialing application. I took time to review and export it into our credentialing database. I began pulling their file together and ensuring information in the application was accurate.

10:00 AM – 11:00 AM: This was my weekly meeting with Annie, our team lead. We reviewed my open licenses and credentialing files, I provided updates on their status, and we brainstormed solutions for roadblocks that were causing delays. Telepsych is a unique industry that doesn’t fit neatly into the established rules and regulations for most medical complexes. Every state medical board, Medicaid program, DEA office, etc. is different in their requirements and timelines. Our doctors live and work all over the country. While we can’t be experts in every state, we can both pool our knowledge as a team and get really good at perusing Google search results. We come up with creative strategies to make things move faster and happen, even when the surface level answer is “no.”

11:00 AM - 12:30 PM: I started and completed the initial application for the Kansas medical license I was assigned that morning. I sent out initial requests to people that needed to complete forms on the provider’s behalf - their references, postgraduate training program, medical school, etc. I prepped a lengthy email with fingerprinting instructions for the provider to complete a background check submission.

12:30 – 1:00 PM: I realized what time it was, checked if anyone else was going to eat lunch, and warmed up something that probably was in my fridge for multiple days. The miserably hot Austin summer had already begun, but we ate lunch on the patio anyway.

1:00 PM - 1:30 PM: I found out that there was an issue with Florida Medicaid not reimbursing one of the three providers I’ve implemented at a clinic. I hopped on the phone, and after many transfers and hold periods, I found out that the hold up is due to a seemingly insignificant spelling discrepancy. I informed the clinic of how they needed to proceed to correct the mistake - crisis averted!

1:30 PM - 3:00 PM: I powered through the three credentialing applications I needed to complete for one of my implementations. I was introduced to the clinic’s credentialing team in the morning, and I want to get the provider’s information to them as soon as possible. I filled everything out that I could, sent it over to the clinic (along with the supporting documentation I had on file), and informed the provider that I needed a copy of their undergraduate diploma to proceed. I also sent the provider  step-by-step instructions on how to get their drug screening and background check completed. 

3:00 PM - 3:30 PM: I worked with a new partner of ours. They had never had telepsychiatry or telemedicine of any specialty in their clinic before, so they were unfamiliar with how to properly credential our provider. Some questions they had were:

Do we need to complete insurance enrollments, or does Iris take care of that?” I explained to them that they will panel the provider with the same insurance groups their onsite doctors are paneled with, and that our credentialing team does not take care of billing, but we do assist with enrollments as needed and facilitate gathering original signatures from the provider. The clinic already had the infrastructure to take care of billing and insurance credentialing, so while we do everything we can to assist with applications and anything else needed, this responsibility lies with the partner.

Are there things that Iris has already verified that we don’t need to take care of?” I let them know that Iris does our own internal credentialing process, but the clinic will still need to complete their normal credentialing. We are aiming to become accredited with the Joint Commission, so we should be able to complete credentialing by proxy in the future, but for now we cannot offer that under most circumstances. I listed out the documentation I already had on file for the provider as part of our process: diplomas, board certificates, etc., and said I would send over whatever else they may need. Even though we can’t eliminate their credentialing process, we try to make it as effortless on their part as possible, especially for the clinician. 

If they have to go through our credentialing process, they will be required to provide proof of immunizations.” Our providers are normally exempt from requirements like this since they are not working onsite and interacting with patients, which is a benefit of telemedicine this clinic had not run into before. This would only be necessary if it was within the partner’s bylaws and therefore unavoidable. The clinic agreed after hearing this explanation that providing proof of immunizations would be unnecessary. One less requirement to check off the list, and that much faster that our clinician can get to seeing patients!

3:30 PM - 3:40 PM: I got a call from one of my providers that I was getting a California license for. They had clarifying questions about the fingerprinting process and what exactly they needed to bring with them. I answered their questions, discussed what to expect next, and the provider scheduled their fingerprinting appointment.

3:40 PM – 4:00 PM: It had been several weeks since a provider’s medical license application was marked complete and in final review. I spent this time on hold with the board for a status update, and I found out there was an oversight. They said they’ll issue the license in a few days. (Surprise - it doesn’t get issued, and I called the licensure analyst back a few days later.)

4:00 PM – 5:00 PM: Today was our monthly credentialing postmortem meeting. The team gathered to discuss issues, mistakes, and lessons learned from the past month. The topics can range from something as small as an error on an application causing a short delay in processing a license application to something much more consequential. Every mistake is a learning opportunity, and with fifty states worth of regulation, we run into a lot of learning opportunities! At the end of the meeting, we blind-graded ourselves on our general success that month in our resolutions. I graded myself a B+. Once the grades were revealed, our average for the month was approximately an A-.

And that’s how it’s done, folks! This is a fairly typical day in the schedule of one of our Licensing and Credentialing Coordinators. Every day is a little different, though, and that’s what keeps it exciting! Telemedicine is an ever-evolving field with plenty of challenges and hoops to jump through. We take it one hoop at a time.

About Iris Telehealth

Iris Telehealth is a telepsychiatry provider organization made up of the highest quality psychiatrists and psychiatric nurse practitioners. Our mission is to provide underserved communities with access to the best mental health specialists and prescribers. We are owned and operated by doctors who understand what patients need and have earned a reputation for providing outstanding customer service. Iris values building strong professional relationships with our partners and their staff. We are dedicated to understanding your organization’s needs and operational goals because we recognize that your success is critical to our own.

Iris Telehealth has helped countless hospitals and community health organizationsacross the country add telepsychiatry to their list of services. We believe everyone should have access to compassionate mental health care, and we have made it our mission to find innovative, affordable ways of making this possible!

Want to learn more?

Click here to download a free telepsychiatry guide.