Oftentimes when medical practice employees leave and move to another job, no one really knows every task that they performed until it doesn't get accomplished or you find out in a bad way. Luckily, that did not happen to me, but it certainly could have.
Our practice just assumed that jobs were being done, and tasks accomplished. We have now taken steps to review employee access to our PTPN network (an organization for rehabilitation providers) and data systems on a quarterly basis. Your practice should do the same — if you do not have a series of checks and balances in place, you could get caught in a bad situation.
I was recently reviewing credentialing and contracting and found a provider who had simply changed from one practice location to the other was dropped from the PTPN network, and that there were other providers who no longer worked for us who were still on the contract. I also found that a new employee's application for credentialing was dropped by the network for unknown reasons. So instead of sitting and waiting around, I jumped in and we're working on fixing all of these missteps. These can cause claims to process out of network, incurring a higher cost-share to some patients. Since we pay per physician, we were able to cut our costs to the network by about four people, and still add the two back.
Another area that I was looking at is the practice's EHR program. There were providers who were still checked as "active users" who are no longer with the practice. More licenses were purchased simply because a box was not unchecked at the time the provider left. You should also monitor if you have a change of status for a treating provider. For instance, if you have students who are working with your group, they graduate, you hire them, and they get their treating license, you will need to update their treating status in the EHR system. This can also lead to claim denials or processing out of network if you don't. On top of this, if you do not remove access for a departing employee out of your systems, you are opening up yourself to a HIPAA violation.
The best way to manage this is to create an employee exit checklist that includes these areas for review and action:
• Turn off all email
• Remove from all software programs
• Remove logins to insurance company websites (benefits checking, etc.)
• Change screen saver and login passwords
• Be sure you get all facility keys back
• Make sure voice mail gets changed
• Alert third party vendors (including billing and office-supply companies) that the employee no longer works for you
• Cancel medical insurance/sign employee up for COBRA
There certainly can be other areas to review, but the most important thing is to have a checklist and quarterly review process in place before a problem erupts.