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ARNG CentralizedCredentialingOctober 2008The National Guard – Always Ready Always There
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthOverview Provider Credentials File (PCF) managementtransferring from all 54 States and Territories toMilitary Credentialing Solutions (MCS) Strategic partnerships with leading credentialingorganizations to gather and verify credentialinginformation Incremental transition from May 2008 to August2010Office of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There2
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthExisting ARNG Credentialing Practices Each State/Territory State Surgeon’s Officeresponsible for all credentialing actions––––File maintenancePrime source verificationPrivileging requestsLocal privileging Military credentialing process separate anddistinct from civilian credentialing activitiesOffice of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There3
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthRationale for Change State/Territory Credentialing Coordinatorchallenges–––––Competing priorities for time (often an additional duty)Lack of resources (computer access, PSV costs, etc.)Frequent turn-over in personnelInconsistent trainingProvider frustration with process 54 Points of contact difficult to track for externalagencies Delays in privileging when requests incompleteor not to standardOffice of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There4
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthBackground ARNG contracted Tenon Consulting Solutions(TCS) to perform thorough assessment ofcurrent processes and make recommendationsfor improvement ARNG accepted recommendation to centralizecredentialing and to leverage advancements incredentials management in the civiliancommunity Military Credentialing Solutions (MCS), asubsidiary of TCS, established to manageprocessOffice of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There5
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthStrategic Partnerships (1/2) Military Credentialing Solutions– Oversees entire ARNG credentialing process– Staffed by professionals with extensive militaryand civilian credentialing experience– Maintains close relationships with StateCredentialing Coordinator, MTFs, and otherappropriate agencies to ensure information isshared and available for privileging actions– Single point of contact for providers and otherswith credentialing-related questions/concernsOffice of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There6
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthStrategic Partnerships (2/2) Council for Affordable Quality Healthcare (CAQH)(www.caqh.org)– Universal Credentialing DataSource (UCD) providesstandardized credentialing application– Accepted by multiple states and major insurancecompanies– Over 600,000 providers registered nationwide to includeapproximately 20% of ARNG providers, thus providing keylink between civilian and military credentialing Anthem Credentialing Services, Inc. (ACSI)(www.anthem.com/credentialing)– Credentials Verification Organization (CVO)– Part of the WellPoint family of companies– Maintains credentials for over 65,000 providers nationwideOffice of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There7
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthARNG Centralized Credentialing Process(1/5) MCS confirms provider information, obtainscopy of existing PCF, and directs provider toinitiate centralization process Provider logs into CAQH(https://upd.caqh.org/das/) and completeselectronic application Provider sends other required credentialingdocuments to MCS to meet standards of AR40-68Office of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There8
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthARNG Credentialing Process (2/5) MCS submits completed CAQH applicationand supporting documents to ACSI IAW AR 40-68, ACSI ensures all documentsavailable, performs prime source verification,and obtains letters of reference ACSI provides completed credentials packetto MCS via scanned (.pdf) formatOffice of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There9
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthARNG Credentialing Process (3/5) MCS performs final review of credentials– Ensures that file meets standards– Conducts thorough risk management assessmentto check for and document adverse information oritems of concern– Enters all information into CCQAS– Prepares for presentation at CredentialsCertification BoardOffice of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There10
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthARNG Credentialing Process (4/5)Credentials Certification Board (CCB)– Composed of members of the ARNG MedicalAdvisory Council (the 54 state and territorysurgeons) with MEDCOM and NGB appointedmembers– Reviews each provider every 2 years– Determines if any obstacle to privileging exists– Makes privileging recommendations (but does notgrant privileges)Office of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There11
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthARNG Credentialing Process (5/5) MCS finalizes credentials file– CCB decision letter added to file– Any additional information added to CCQAS– Electronic version of PCF uploaded to CCQASOffice of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There12
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthSystem DesignOffice of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthOn-going Credentials Management Provider re-attests to accuracy of credentials inCAQH every 120 days CAQH provides on-going sanctions monitoringof over 400 agencies that alerts MCS to anyadverse action taken against an ARNG provider ACSI provides perpetual re-verification ofcredentials MCS ensures complete file review andpresentation to CCB every 2 yearsOffice of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There14
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthARNG Privileging Process Each State/Territory remains responsible forprivileging providers for local duty and forsending ICTB to external privileging facilities Once provider has completed the centralizedcredentialing process, State/Territory utilizescredentialing information supplied by MCS inCCQAS to prepare and transmit ICTB Privileging facility can access the electronic PCFonce record received in CCQASOffice of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There15
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthTransition Timeline Select number of states/providers beingtransitioned every quarter over a two-year period First set of providers transitioned as of 22August 2008Office of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There16
LEGENDPhases:PilotIIIIIIIVVVIVIITransitionDateMay 08Aug 08Nov 08Feb 09May 09Aug 09Nov 09Feb 10CCBDateAug 08Nov 08Feb 09May 09Aug 09Nov 09Feb 10May 10Projected ARNG CentralizedCredentialing ImplementationPlan (with MedAC Regions)REGION IREGION IVREGION VIIREGION IIREGION VIREGION V#REGION IIIa/o 6 AUG 2008MAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.mil
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthProvider Exceptions Providers who are currently deployed ormobilized away from their home will be delayeduntil the end of their assignment Providers pending ARNG separation will not becredentialed Providers who are in an AOC-producingprogram or who have not been granted theirinitial professional license will be delayed untilthey have graduated and gained their minimumcredentials (license, certification)Office of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There18
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthMilitary Credentialing Solutions Contact information1600 Parkwood Circle, Suite 340Atlanta, GA comhttps://www.us.army.mil/suite/page/547348 Operations ManagerPriscilla BerryCOL (Retired), AN (Prior ARCCA Operations Manager)678-202-5597 ext. 209pberry@militarycredentialing.comOffice of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There19
Individual Medical Readiness is a Team Effort to Conserve Fighting StrengthARNG Point of Contact MAJ(P) Scott ArcandARNG Quality Management Officer (and ContractingOfficer’s Representative)(703) 607-9531; DSN 327- ; fax -7187scott.arcand@ng.army.milOffice of the Chief SurgeonMAJ Arcand / NGB-ARS / 703-607-9531 / scott.arcand@ng.army.milThe National Guard – Always Ready Always There20
Strategic Partnerships (2/2) Council for Affordable Quality Healthcare (CAQH) (www.caqh.org) - Universal Credentialing DataSource (UCD) provides standardized credentialing application - Accepted by multiple states and major insurance companies - Over 600,000 providers registered nationwide to include approximately 20% of ARNG providers, thus providing key
