Come April 1, in a coordinated effort by the Massachusetts Medical Society, the Massachusetts Hospital Association and seven healthcare plans, nearly 21,000 active physicians in the state will be able to either submit or update their credentialing information with two new, widely accepted forms.
The next goal -- the capability to update credentialing information online -- is about six months to a year out, according to Thomas Sullivan, M.D., president of the Massachusetts Medical Society. But for now, Sullivan said he's happy with the current agreement, which will use forms in a printable format accessible via the Web.
"It was very, very difficult," Sullivan said in a telephone interview after announcing the deal today. "We spent over 100 hours in meetings over this."
For paperwork-strapped physicians, Sullivan said the agreement was "a huge breakthrough."
Negotiators working out the arrangement were benefited by the relatively low market penetration within the state of national healthcare payers, which want their own national credentialing procedure, Sullivan said.
"Fortunately, the great percentage of our people in Massachusetts are covered by local plans," Sullivan said. The seven plans participating in the agreement enroll about 85% of state residents covered by private insurance outside Medicare and Medicaid programs, he said.
The participating payers that will honor the new forms are Blue Cross Blue Shield of Massachusetts, Fallon Community Health Plan, Harvard Pilgrim Health Care, Health New England, Neighborhood Health Plan, Network Health and Tufts Health Plan.
Also starting April 1, the plans pledge to finish the credentialing process on 95% of complete initial applications within 30 days of receipt.
Sullivan predicted the MHA will have little trouble lobbying its 100 or so hospital members to accept the new forms -- one longer form for initial credentialing and a shorter form for renewals. In Massachusetts, he said, many physicians are employed by hospitals, so the burden of keeping their physicians' credentials up-to-date with maybe a dozen different health plans falls to hospital staffers.
"This is a huge, huge savings for them," Sullivan said.
Sullivan said the forms are already up on the MHA Web site and will be up on his association's site in a few days.