NP Launchpad
In this podcast, a dynamic trio of Fitzgerald Health's NP faculty members show you what works and what doesn’t in clinical settings and beyond. From logistical subjects like licensure, salary negotiation, and documentation to emotional topics like self-doubt and burnout, our hosts guide you through the complexities of practice.
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NP Launchpad
EP 3: Credentialing & Privileging 101
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NP credentialing, decoded. Establish yourself in the nurse practitioner field by streamlining administrative processes, collecting stellar recommendation letters, and keeping a squeaky clean background. Here, we discuss best practices for privileging, and when it’s best to ‘stay in your lane’ during clinical scenarios.
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Welcome to NP Launchpad, presented by Fitzgerald Health Education Associates, the podcast created for newly graduated nurse practitioners navigating the transition from school to clinical practice. Hosts Jason Gleason, Christopher Gleason, and Vanessa Pomarico-Denino deliver real talk, real experiences, and practical guidance to help you succeed from day one. So if you're ready, let's jump right in.
Vanessa Pomarico:Hi everyone, and welcome to episode three of NP Launchpad. My name is Dr. Vanessa Pomarico, and I'm going to be the lead for this episode. And today we're going to talk about the journey of credentialing and hospital privileges. I'm so delighted to be back with my friends and my colleagues, Dr. Jason Gleason and soon to be Dr. Christopher Gleason. Welcome, guys.
Christopher Gleason:Thank you.
Vanessa Pomarico:All right. So what are we going to walk away with today? We're going to talk about the nuts and bolts of credentialing and privileging. It can often be a very frustrating and lengthy process. We talked a little bit about it in our last episode, but we're going to give you the tools that you need to have a smooth journey. And so be sure that you share the information on this podcast with your classmates, your friends, your colleagues, and better yet, invite them to subscribe to our podcast so they can learn this and so much more that's going to be coming in our future episodes. Remember to send any of your questions to our email is nplaunchpad at fhea.com. That's nplaunchpad at fhea.com and we'll get to some of your questions. A little bit of a disclaimer to make our legal department happy. This is really used for education only. We are not giving you any legal or clinical advice. And we encourage you to reach out to your appropriate legal professionals, your local mentors, your practice managers, any of your state agencies for any specific issues that you might have. All right, so let's launch into this and talk about some prereqs for credentialing. So, Jason, before credentialing can begin, what does an NP have to have in place?
Jason Gleason:Boy, I think this builds upon our last podcast episode, which I hope our audience really enjoyed and got a lot from. It's a dry topic, isn't it? Credentialing, licensure, DEA. But it's the foundation for what you do. So I would say to carry over from our last episode to be very, very well organized. Be easy on yourself, but be organized. That's the one topic or one piece of advice I'd pass on, one tip is just to be super organized with this stuff because if you fall behind, you're going to fall off a cliff and it's going to take a lot of time to get back up there.
Vanessa Pomarico:Sure. So we need to have, obviously, you know, in some states, you still have to have both your RN and APRN license. I know in Connecticut we have to have both. So we have to have both of those active. We need to make sure that we have our national board certification, right? A and P and ANCC, which Christopher spoke about in our last podcast. Obviously, we need to have graduated from an accredited program, either an MSN program or a DNP. And then Christopher spent a fair amount of time in our last podcast talking about, you know, our DEA registration, our NPI number, and then going through all of the verification process. So, Chris, can you talk a little bit about how long the process for credentialing can take?
Christopher Gleason:Gosh, the to be honest, the process for credentialing can take months. It truly can. You have to have so much, so much ready. Um, especially in the the initial process when you're applying for your licensure and you're you're applying to, you know, to take your boards and things of that nature, you have to have your transcripts ready, you have to have um all your all your education excuse me, you have to have all your education ready. So it can really be a lengthy process. And then touching back on our last episode when we were talking about background checks and when we're talking about fingerprinting, that in and of itself can be a lengthy process and can take weeks weeks to accomplish. And as Jason touched on in the last episode, you know, in some states, especially those more rural, it can you can travel up to 100 miles to get to these places that that um to get your background checks and your um your fingerprints done. So it's definitely a lengthy process.
Vanessa Pomarico:So true. And you know, matter of fact, I knew somebody that was applying for a job within our organization, and it took them so long to get credentialed that they took a job somewhere else. Um and it was it was actually about nine months after they had been offered the position. So it can be quite lengthy. So credentialing and privileging are not the same thing. So let's talk about credentialing first. So credentialing is basically verifying who we say we are, right? It's our licensure, it's our education, it's our work history, and that kind of thing. Where privileging is really about granting permission to perform specific tasks for whatever or procedures for whatever position we have applied for. So it's basically like a menu of what you can and cannot do within your scope of practice or for that particular position as well. But when we talk about the credentialing, again, you know, expect those lengthy timelines. What do you think nurse practitioners who have graduated and are waiting for that timeline, what do you think that they should be doing with their time in between the time that they've graduated and the time that they're granted their credentialing and their privileging?
Jason Gleason:Boy, I I would say get your checklist out and just go down the checklist and have everything ready. I one one thing I would recommend not doing and avoiding this is piecemealing this stuff, right? Because let's say you get a job at a hospital and they have a credentialing department within their medical staff office, and you're working with those very kind people, and they are very kind people that do this kind of work for us, because who would like to fill all this paperwork out day after day after day? None of us would, right?
Vanessa Pomarico:Right.
Jason Gleason:Pretty monotonous. But um, be kind to them, but don't piecemeal it like, oh, here's my DEA and here's this and here's this. Have it all ready to go in one packet. What I would actually recommend is this get all your ducks lined up, get everything set, right? And then go into that medical staff office because you will shine. You'll be like their favorite person, you'll be their hero. Bring them a packet, an entire folder with a very nice cover letter that says, Thank you so much for doing this. I appreciate you. Here's what I've included in this folder itself, my credentialing folder. Everything's ready to go, everything's signed. If you see anything I need to add, please let me know. Here is my private email, private um uh phone number, as well as my professional contact information so you don't miss anything and make it easy for them to reach out to. And then here is the special sauce to this. When you go into that medical staff office, again, they work their butts off. And this is not fun stuff to work on, pretty boring stuff, right? And we hate working on it. So you know how they feel about having a stack of these to do for multiple providers. So here's here's the special sauce. You want to know the secret? Bring them donuts. Bring them donuts. Be nice to them. They're stuck in a hole, usually an office without windows, and they're working all this stuff for us. Make sure you treat them well. And donuts, they do help. Not as a bribe, but because you appreciate the work that they do. So that's what I'd recommend. Stay organized, don't piecemeal things, and don't forget the donuts.
Vanessa Pomarico:Christopher, what do you think in terms of working? Can can nurses who have they're now um licensed and they're certified as nurse practitioners, what do they do? What do you think that or suggest that they do in the interim before they're able to start working as their NP job? Can they work as nurse practitioners?
Christopher Gleason:I believe in some states you can actually work even before your certification, uh, even without a certification. I believe in the actually the state of New York, you can actually work without a certification. Well, I don't recommend that, however. Um, but that interim period, it's you know, I I concur with what Jason said. It's just making sure to keep everything so organized and and so well thought out. And, you know, going again, touching on what he said, when you're going into that credentialing office and giving them all these uh all the paperwork and having them fill out all of this information for you, making sure to, you know, to express your appreciation for them because again, what they do is not an exciting topic, and what they do is not an exciting job. So making sure to appreciate them is key.
Vanessa Pomarico:So important. And I know you know our medical staff office is actually in the basement, in like the bowels of the original hospital. So it's not in a very fun area. Now, uh, you know, we we work in entirely different uh clinical settings. So I know what credentialing looked like for me. Um, and I remember having to make several copies. So instead of bringing in one copy, I made about eight copies of everything because you might have one person working on Blue Cross Blue Shield, someone else is going to work on Medicare, someone else is gonna work on Aetna. And so I kind of made it easy for them and I made a complete packet for every one of the payers, just to be, I know it was kind of like overkill, but I just didn't want to create any extra work for them. But Chris, like you said, not in not every state can you work as a nurse practitioner? And so I remember that those three months while I was waiting for my credentialing to come through, feeling like for the first time in a lot of years, I was able to just be a nurse and not have to think about anything else. I wasn't thinking about school. I wasn't thinking about what paper I had to write when I got out of class. I wasn't thinking about, I have to work six nights in a row in order to get three days off so I can go to clinical. And so for me, it was it was kind of like that honeymoon period before I became a nurse practitioner. Um, but and you had said that you didn't recommend, you know, some places will let you work as a nurse practitioner. But there's there's some downsides to that legally as well. And those are some of the things you have to bring up when you are with an employer that says, oh, don't worry about the credentialing. We'll just bill it under our name, but you'll see the patients. And I, you know, that's that's opening up a lot of red flags for a nurse practitioner to start their career off on the wrong foot. What do you think about that?
Christopher Gleason:The um I think you're absolutely right. The the legality of that alone, I think, just opens up a can of worms that's not that's not worth it. If you're going into a practice or or a job where they're saying, you know, your your credentialing isn't isn't finalized, but that's fine. You can still see patients and you know, and we'll just bill it under this this person. Number one, that's billing fraud, technically speaking, because you're the one that's providing the service, and they're the one that that's billing for says billing fraud, and that should be a huge red flag for you. And and you know, the fraud aspect aside, there's a whole there's a whole piece of you know, you're you're responsible for this patient, yeah. This other person is supposedly billing for you, or you know, or taking no. I I highly recommend against that. And if you see, if you're going into a job that even suggests something like that, that should be a huge red flag for you to to to walk away from that.
Jason Gleason:And understand that, you know, I didn't know is not a good defense. They will go after you like crazy and they don't care. They don't care. You know, fraud is fraud, and and if you didn't know, of course they consider that somewhat, but uh versus if you go in with malice and intention to commit fraud. But yeah, uh I didn't know is not a good defense for anything. So be sure you know. And if if your gut is telling you this doesn't seem right, don't do it. Don't do it.
Vanessa Pomarico:So true. You know, and I've I've speak to so many nurse practitioners about this that they'll reach out and they'll say, you know, I got this job before I even graduated and I haven't gotten credentialed yet. And they said not to worry about it. And I always say, you know what, we worked really hard for our licenses. And even though nurse practitioners are far more accepted now than Jason when you and I first started in practice, um, you don't want to give one more thing for the medical community to say, see, this is what nurse practitioners do, and this is why they can't be trusted. So you don't want to do anything that goes against your gut. Exactly. So was it any different working for the VA as opposed to so both of you worked outside of the VA? Was the credentialing process any different when you went into the VA? Was it any more streamlined or is it pretty much the same wherever you go?
Christopher Gleason:I I think the VA was a little bit simpler. So the process to get into the VA can take, can be a long pro long and arduous process. I'm not gonna lie about that. But as far as the credentialing goes, because we're a federal agency and the VA doesn't bill, necessarily bill outside insurances. So like at Blue Cross, Blue Shield, things of that nature, the VA doesn't bill those. So they don't work with those companies. And as a result, when we're credentialing, the they don't have to credential with those companies as well. So that makes it that makes it a little bit more streamlined, a little bit easier, I think. What do you think, Jason?
Jason Gleason:Yeah, it's pretty centralized and they're so helpful. You know, our medical staff folks and people that do credentialing privileging for us, they do a lot of the the legwork for us and have us sign forms. But uh with that, here's a good piece of advice and a tip. Know what you're signing, right? Because in that busy day where you've seen 12 patients and you're they're you're there till you know after your lunchtime or whatever, it's only the morning hour. And then they come with you with a stack of forms. You're like, yeah, whatever, just sign away. Make sure you read through every form, right? You've got to know what you're signing, otherwise, you know, you open yourself up for liability issues and fraud and those kind of things. But yeah, the VA is amazing actually for credentialing. Their teams work so hard and so diligently in uh in keeping it organized and just very user-friendly for us. So it's been a deal. But getting into the VA because they do want the best of the best out there, they do want all your ducks in a row and and and everything. So it takes a little while to get into the VA as an employee, but once you're in there, they they do treat you very well as they should.
Vanessa Pomarico:So you're so fortunate to work for such a great organization.
Jason Gleason:Yeah.
Vanessa Pomarico:So we talked a little bit about credentialing. Let's kind of now move into privileging. So privileging is really what your scope of practice is going to be, your clinical scope approval, right? So it so privileging is really what you're allowed to do clinically within an organization or a position. So let's say, so I'm a family nurse practitioner, and let's say I got hired by an organization and I'm going to be doing uh, you know, some type of perioperative services, or I'm gonna go work, you know, in the um in the ICU. But I'm I've been trained as a primary care provider, and now I'm taking a job because maybe I worked in in cardiac ICU as a nurse. Is that the same thing working as a cardiac nurse and now as in a family nurse practitioner or an adult nurse practitioner? Is it safe for them to practice in an area like an ICU?
Christopher Gleason:No, no, absolutely not. You're you're on a you're on a completely different scope as a nurse practitioner versus an RN. So in your tr your training's gonna be completely different. And you can only, when you're doing privileging, you can only ask for privilege or you should only ask for privileges in in things that you've been trained in and things that you have experience in. And well, and also things that you're gonna utilize in your practice. If you're not, I mean, myself as a family nurse practitioner, um, I can request, you know, insertion of a foley. Am I going to do it at practice? No, I'm not. So why would I request that privilege? So I think the same thing goes in goes into consideration when you're doing, you know, if you have that experience as a cardiac RN and you're now a family nurse practitioner going into that same situation, you know, you have to be really, really uh mindful of those things.
Jason Gleason:Oh, absolutely. You know, here's a story to really hammer that point home. And our our friends and our colleagues out there, you're gonna you're gonna run into these things. You're gonna run into them. It's real life. But I worked in the emergency department in a setting and I had a patient come in with a peritonsillar abscess, classic peritonsillar abscess. Everything was shifting over, and they had the muffled voice. They weren't in a crisis, but they were uncomfortable, right? And we had to take care of it. And so I, as the new nurse practitioner in the department, I walk over to one of my physician colleagues and I say, gosh, you know, I got a patient peritonsillar abscess. What is the next step here? What should I do? And uh, and they said, All right, here's what I'm gonna tell you to do. I'm gonna write this down for you. All right, now you get all your equipment, and I want you to get like a 14-gauge needle on a syringe, and I want you to stick it in that abscess and draw out all that perulent discharge, but don't hit the carotid artery. Whatever you do, do not hit the carotid artery. And they wrote this down on a post-it note, like these instructions. And I go back to my area and I'm like freaking out. I'm like, I'm not gonna do this. My gut is telling me, Gleason, do not do this. You've never done this, you're not credentialing, you're not privileged for it. This is not your area, right? You are not in your lane. Do not do this. You're gonna hurt that patient. So you'll run into those areas where you'll have colleagues even saying, Oh, just go do it. It's fine. You can do that. I'll walk you through it. Don't fall for that. So, in that case, what did I do? I would go back to my office. I called the ENT specialist because you know what to do. You know what's right, right? And so I called the ENT specialist. They came in and they actually took the patient to surgery. So thankfully, I did not stick any sharp instruments into their carotid and have them bleed out in the ED right there and die in front of me. So, but you'll be faced with that. And they're tough decisions because you know what, peer pressure, we think of it in high school or grade school, but it carries over into professional world issues too, like that example I just gave you. And you kind of feel like a pinhead, but never, ever, ever, ever uh not listen to your gut. You always want to listen to your gut, and it's okay to say no and say that's out of my lane. I'm gonna do the right thing. And what is that? Get the patient to where they need to be seen by the providers that are privileged to do those procedures.
Vanessa Pomarico:That's right. Know your resources. So our privileging is really the procedures that we can perform. But in a court of law, like you said, if if you kind of cave to that peer pressure and said, Oh, okay, sure, I'll I'll try it. I'm game. What is it, the the old saying, see one, do one, teach one? You know, and then you did something and there was a poor outcome with the patient, in a court of law, they would say, Jason, what in your primary care education prepared you to drain a peritonsillar abscess or drop a swan line or intubate a patient? It's it's not part of it. But don't we see that? I don't know if you see it in the VA as much as we see it out in the community, but there's a lot of primary care nurse practitioners who are being hired in the ICU to be ICU hospitalists. And that's again, in a court of law, it's not going to hold up if they ask what in your primary care, you know, education prepared you for this. So really important that our listeners understand that just because you might be an expert ICU nurse doesn't mean that you've been prepared appropriately to do the privileges that are outlined outside of your scope of practice for what your education has prepared you for, right?
Jason Gleason:Well, and we we run into this all the time, Vanessa, when we're teaching board review for up-and-coming NPs, they're they're in an FNP program, right? Or adult-gero, but they love cardiac or they love women's health, what or love neurology or neurosurgery. And even though they're getting a degree and being board certified as an FNP or adult-gero, they're gonna go into that specialty. And in most states, that's okay. That's okay to do. But you have to have that privileging in place, right? Make sure that that is done because, like Vanessa said, they will they will just eat you up alive on a witness stand, liability-wise, you won't have any defense whatsoever. You know, I I love what a colleague told me years ago, and it really makes sense. With providers that have a degree, let's say in in family nurse practitioner, a degree in that or adult juro, but they go to work in an emergency department. Well, to the patient that is going to that emergency department, their expectation is, because it's advertised everywhere, emergency department, here's our services for emergencies, life-threatening issues. Their expectation is that they're going to the emergency department not to be treated by a primary care provider, an FNP, but to be treated by somebody that's privileged to provide emergency care, right, and training. And that's where a lot of new NPs, I think, can fall into a big hole, a big trap of not knowing what they don't know, right? And it's okay. You don't have to know everything, but don't put yourself out there and make sure all your privileging is in there because a huge liability issue otherwise. So great points, great points.
Vanessa Pomarico:Right. And our and our remember that our privileging, even though we were showing our education and our training, privileging also demonstrates competence, right? And it also has to do with the state scope of practice laws as well, in addition to any of the organizational policies. So uh, you know, our listeners really need to make sure that they have all of those checks and balances in place and not going outside of their scope of practice. But even after we've done the credentialing and the privileging, remember we're not done because what happens after two or three years? We get that dreaded email. It's time for you to re-credential. And while it's not as much of a lengthy process, you generally, I know in our organization, and I know I'm not sure I'm not sure if it's the same with yours, and Christopher, maybe you can expand upon it, but we generally need to have another provider uh review three patient records and then do a letter of verification. Is it the same for you at the VA?
Christopher Gleason:Yes, yeah. The uh we have to have um letters of references from our colleague uh providers and um throughout actually throughout our uh throughout the year, we have people that review our charts to make sure that our charting's on point, to make sure that our our um our training's on point. So yeah, it's it's a similar process for us as well.
Jason Gleason:Such a great system. It's really the VA has it down very well. For patient safety.
Vanessa Pomarico:Yeah.
Jason Gleason:And our safety and our you know, our liability and that kind of thing. So our best interest as well.
Vanessa Pomarico:Amazing. All right. Well, uh, you know, on a on uh continuing on that vein. Jason, can you talk a little bit about the CAQH? That's the Council for Affordable Quality Healthcare. Can you talk a little bit about what that is and how we work with it?
Jason Gleason:You know, here is the deal with that. Actually, I am not an expert in that topic at all. So I'm going to pass on that one over to Christopher or you to tell us. But I'll tell you that my experience with that is that again, often there are departments that manage those kind of things for us. And it's like, you know, we're so used to managing disease and ordering medications and tests and doing all the good stuff that we're we're very good at. But Council for Affordable Quality Healthcare, I'm familiar with the concept. But as far as all the logistics go, though, I have to be honest. And again, I'm being real and honest with everybody out there, as many of you are also struggling with these concepts sometimes. Somebody else usually handles this for me, and then I just go along with what they need me to do as a provider.
Vanessa Pomarico:So and you know, it just goes right along with what we just talked about, knowing what we don't know. Oh yeah, right. Absolutely. So so there's a little bit about the CAQH pro view. Chris, are you familiar with the with the Pro View?
Christopher Gleason:I'm not familiar with the Pro View, but it's interesting because as um because we both belong to the VA, the CAQH actually is not part of our um credentialing uh responsibility or process. The I do know that um previously when I worked for other organizations, the CU, I was part of the CAQH, and it was, you know, uh there was an entire department that was in in charge of it and getting the getting the um information to the people that needed it.
Vanessa Pomarico:So the uh it was a lot of it goes along with what we've already mentioned in our in our previous two um podcasts about setting up your profile, you know, keeping it clean, keeping contacts, but the pro view actually has everything in there so you don't have to continually repeat everything. And it has, you know, your correct addresses, your phone, your email, your practice location, or if you have multiple locations or different practices, it'll have all of that information in there. And then it gives you the ability to upload your key documents, things like your licenses, your board certification, and the all-important malpractice, which we'll talk about in a future episode. And that really is so that those verifiers can move along, move the process along a little bit more quickly. The problem is one of the pitfalls with the CAQH is that it does require a re-attestation about every four months or 120 days, or if something changes. But again, having those things at the tip of your fingers and having your um the um passwords to get into them easily is really going to make things go very, very quickly. And keeping things consistent, using the same name, this becomes a problem with people when they get married and if they hyphenate their names or they change their names or if they've moved. Um, those are the kinds of things that kind of send up some red flags and will delay the process if you don't stay on top of it. Um, and as we had mentioned in the previous uh podcast, is about staying on top of those things so you're not scrambling at the last minute to get it um get it all done. And then, you know, just a reminder to put a um a reminder in your phone to send something up a couple of months before you're due for all of that. So let's talk a little bit about the nurse practitioner data bank. I always say that this is a list that you never want to get your name on. Um, do either one of you want to speak to the to the NPDB at all?
Jason Gleason:I'm gonna defer to you on this one. I can speak to it by telling you I am not on the list. Neither am I. The nested I am not on the list. And because I'm not on the list, that's a good thing. But please give us an overview of what this is.
Vanessa Pomarico:So basically, what the Nurse Practitioner Data Bank, it's a national database of um adverse actions and malpractice payments, which is why we don't want to be included. This is not part of the best dress list. Um, but hospitals and any of the payers, any of the insurers can query it to make sure that you are not on that, excuse me, because that's one of those lists that if if your name pops up, obviously they're gonna pass on you and you're not going to get the job for that as well. Um, there's also another list called the system for award management. It's sam.gov. Uh, that also is another database that has some of those exclusions that are also used for federal program checks. So, probably when the two of you were being hired by the VA, you might have very easily have uh gone through one of those um those online checks to make sure you were not on that list. So let's talk a little bit about some common timeline traps and how we can speed things up ethically. One of the things that people have a real hard time with are gaps in their employment. You know, when they uh go from one job to another, but they might have three months in between. We'll talk some more about that as we get into some of our future episodes. But for this particular episode, how would either one of you, let's start with Jason, how would you, uh what would you recommend? What would be one thing you could recommend to somebody who had a lot of gaps in their employment? How do they explain that away?
Jason Gleason:Boy, because life happens, right? And all of us have experienced that. I know I certainly have. Um, you know, be honest. Absolutely be honest. Because if you're not honest, they're gonna find that out, right? Because when they see those gaps, that's a red flag for them to dig deeper. And you bet they're gonna dig deeper because they want to have the best person for that job. So be completely honest. And they're human beings, they understand we are too. You can be real. Gosh, I didn't work that year because I had a family member die and it was traumatic for me. Or you know what? I couldn't find a job. I just could not find a job, or are you another life circumstance got in the way. Um, be completely honest, though, because they will know. They will know if you're not. So that's the big take home there. Be absolutely honest about those gaps and be very, very um transparent. That's what I would say.
Vanessa Pomarico:So, Christopher, how about when you when you have to give references? You know, what do you think about when you have to give references? Because when we have to do privileging and credentialing, we have to give um three references. Do you have any advice for our our uh listeners today about you know how to pick somebody in terms of being a valid reference?
Christopher Gleason:Mm-hmm. Uh when you're when you're picking a reference, make sure that you know that the person that you're choosing as a reference knows your clinical practice. That is key. I mean, you you you're gonna want them, this person is going to um write, write a letter to you for you or or speak to you as as a as a provider. So you're gonna want to make sure that they know your clinical practice, know how well you're um well you uh perform in your practice, things of that nature. That can be really key in that.
Jason Gleason:Well, you know what? I I would add to that. That's such a great point. And what I would add, know make sure that the people know you. But also, you know, if if a colleague comes up to me and says, Hey, can you do a reference for me? Well, that's great. And I do know you, but do I really know you, right? Do I know all your accomplishments and the things that I really want to push for you and make sure that that are really uh marked out and and and spotlighted for you? So, what I'd also recommend, this is so important for our listeners out there, but I also recommend for references is identify good references that know you. But assume this, that they really don't know you that well. They know you, but do they really know you? Now, do they want to know personal stuff? No. But give them your CV and point out, highlight the the accomplishments that you've made, your training, your skills, your talents. This is your moment to shine and make sure that that um person that's your reference knows all that about you, though, so they can speak to that and they can do that intelligently. So prepare them by sending your CV. Because honestly, there is nothing worse than somebody asking me to be a reference. And it's like I I know them, but I don't know about any of their accomplishments except for the day-to-day stuff. Point that out, and that's where the magic happens.
Vanessa Pomarico:And and let's hope that the person that you're asking to be a reference is not somebody that it's going to get to the bottom of their pile and then they forget. You need to make sure because remember that the wheels move very slowly in terms of getting the state to verify your licensure and that kind of thing. But also, too, if you get somebody that's not particularly organized or doesn't pay attention to details, that can also delay your application process for privileging if that person doesn't write your verification in a timely manner.
Jason Gleason:Oh, yeah. Right. One thing I would add to that, fine to wrap that up about references is that by far, this is probably the most important thing to keep in mind. Do not list as a reference your mother-in-law or father-in-law that you do not get along with. Don't do it. Just do not do that. It's a chance.
Vanessa Pomarico:Right. Or even, you know, let's say you had a preceptor that, you know, that that maybe you didn't have a good connection with. You know, putting the, I've had some students of mine that really didn't perform stell as stellar as I would have hoped them to. And then being their clinical preceptor, they'd say, you know, can you write a letter of reference? And I'm very honest with them and say, you know, I can speak to your performance, but let's have an honest chat about how well you did or did not perform. Like I had a student that she showed up late every week. I had to speak to her on more than one occasion about what she was wearing to the office because it was less than professional. Um, she would leave in the middle of the clinical day and go get something to eat and not tell me that she had even left my office. And I had to sit down and say to her, you know, these are the things that you demonstrated as a student. I'm not sure that I would be the best person to write a letter of reference for you because of the experience that we've had. And this is why I kept saying to you as a student, you need to change some of these behaviors because this is all that I'm seeing. And so now you're going out into the real world and you want me to write a letter of reference, but I don't exactly have a very good view of you given how you've performed as a student. So it's hard to write a letter of reference that way. I've gotten better at it that people can read my letter of reference and they can kind of read through the lines. You know, are they competent? Sure. Are they stellar? Absolutely not. But I have to be honest with them. And I've had some people that have actually said, no, I would not write them a letter of reference just because of those reasons. So um make sure that you're selecting the appropriate ones. And like you said, don't select people who were, you know, your your uh anybody related to you. I actually had a college roommate I never worked with.
Jason Gleason:They know about you in ways you don't want them to know, right? Yes.
Vanessa Pomarico:That's so true.
Jason Gleason:Yeah. And when when I so many good points you made, you know, one thing that comes to my mind is that you can't, I mean, everybody has value, even if people screw up, because all of us do that, right? And we're not our best performance every single day of our life. So all of us screw up and everybody has value to make that point. But as a as a person writing a reference, you also cannot put frosting on a turd and call it the most delicious cake ever, right? I mean, no amount of glam up is going to help some folks. Not that they're bad people, no one's bad out there, but performance-wise, you know, you just can't glam it up. One thing that I really think would totally make a slam dunk for somebody if you're writing a reference for somebody or if you're asking for somebody to be uh writing a reference for you is give them specific outcomes, productivity, numbers, statistics. You know, I helped this percentage of patients, or my doctoral study helped this percentage of this population. Give something measurable, objective measurements, have them interwind that throughout the um and weave it into their reference letter. Employers look for that. You know, how is this employee gonna stand out? What are they gonna do for me? Oh, they've done this. This is their productivity and outcomes they've had. Slam dunk. So I'd also recommend that. Be specific because you can use all the fancy words, and again, frost deterred all you want. But in the end of the day, they're looking for outcomes and productivity and how you're gonna make their place better.
Vanessa Pomarico:That's a really great point to make about highlighting some of that because you can get a three or four-page CV that has a lot of fluff in it and not a lot of really pertinent information. So so how do you on that note, and then we'll get back to some of the other resources, but but Christopher, how do you feel if somebody came to you with a letter that they wrote and said, I just put your name on it, but here's a letter of reference I wrote for myself? How do you feel about that?
Christopher Gleason:Absolutely not. The if you're if you're if you are asking me to write a reference for you, then I need to be writing that reference. And and to Jason's point, your point, you know, give me those highlights of of what's gone on during during your career, what have you done, you know, prior to to working here or wanting to work here? And if you're gonna present a letter to me saying, you know, just sign here, that I don't know, it's not really a legality issue, but it's a moral issue for me. I mean, I have to know that you've done these things and and um excuse me, and have proof that you've done these things to put them in a letter. So if you're if you're gonna approach me with a letter and say, here, sign this, it's not gonna happen.
Jason Gleason:Is that why you didn't sign that letter for me that one time? It's because it was for a mortal. At least I know now.
Vanessa Pomarico:So true. All right. So we have some resources that are up on your screen right now, and they will also be in the show notes. These are really important. I know it's a really cut and dry topic to talk about, but so important to get through the credentialing and privileging process. And so those resources are on the screen as well as in your show notes. So now we get to move to my favorite part of our of our episodes is to play fact or fiction. So I'm gonna ask the questions and both of you are gonna tell me if it's fact or fiction. Are you ready?
Jason Gleason:We're ready. Bring it.
Vanessa Pomarico:All right, all right, Christopher, credentialing and privileging are the exact same process.
Christopher Gleason:Absolutely not.
Vanessa Pomarico:Do you agree, Jason?
Jason Gleason:Absolutely. Yep. Yep. They're not the same thing.
Vanessa Pomarico:Not the same thing. All right, Jason, CAQH ProView is commonly used to streamline credentialing data, fact or fiction.
Jason Gleason:Fact, yes, it's very helpful. So easy. Put everything in one place.
Vanessa Pomarico:Yep, so easy. All right, Christopher, hospitals often screen providers against inclusion exclusion lists such as the OIG or the SAM, fact or fiction.
Jason Gleason:Also known as the shit list.
Christopher Gleason:That is true.
Jason Gleason:Stay off the shit list.
Vanessa Pomarico:That's right. That's a that's not the best dress list. All right, and Jason, credentialing delays are always the provider's fault, fact or fiction.
Jason Gleason:No, life gets in the way. Staff in in credentialing offices get behind sometimes. And again, just appreciate the work that they do. But do everything you can to make yourself very organized and make their life easier because that will speed things along.
Vanessa Pomarico:Maybe they forgot to bring the donuts.
Jason Gleason:I know.
Vanessa Pomarico:All right. So I'd like to invite uh our and remind our listeners and our viewers to make sure that you email the questions to nplaunchpad at fhea.com. That's nplaunchpad@ fhea.com, and we might answer some of your questions in a future episode. Um, but we have two questions here. How long has credentialing and privileging taken for you so far? And what's the holdup? And either one of you want to take it. I know we did kind of touch on that, but maybe give me a brief summation of it.
Jason Gleason:I'd say for me it was about two months.
Christopher Gleason:I think it I think it really varies. And to go back to the point of, you know, depending on who you have working in the codenting office, how overworked they are, things of that nature, it can really that can really delay the the process. But as long as you're as long as you're organized and you have all the information that you need and you present all the information that that they need on their end, you know, at two to three months is about it. Yeah.
Jason Gleason:And one thing on that too that I have to bring up is, you know, because I didn't realize this, and many of our audience members out there may not know this as well, but with credential and privileging, especially for renewals, I mean, initially, but even for renewals, I you know, you have to do your part. But there are so many other people in the chain of command or leadership that are waiting for you to do your part and they can't do theirs, they can't sign off on stuff until your part is done. And I think it's uh very disrespectful, very disrespectful for you to kind of drag your feet and think, oh, it's credentialing, I'll I'll worry about that later. When you see credentialing, especially for renewals come up, make that a priority for that day to get that done. They will appreciate you so much and it shows so much respect to them because if you don't, and if it just sticks, stays in a stack on your desk and they are hammering you every week, it's like you need to sign that and get this into us. You're holding up the process, not just for the credentialing office, but your leadership who are looking at you, and that's very disrespectful. So I'd say jump on it, make it a priority. It's your time to shine and make them happy, and that'll that'll make you happy.
Vanessa Pomarico:And you made a very important point earlier in the podcast about, you know, when you hold it up, it also affects billing because you don't want to get that email saying don't show up for work tomorrow because you're not credentialed anymore.
Jason Gleason:Right. Yep.
Vanessa Pomarico:Right?
Jason Gleason:All right, the other question is zero. Thanks a lot.
Vanessa Pomarico:You're right, right? Thank you, right? All right, and what document do they keep asking you for over and over and how are you organizing it? Either one of you want to take that question?
Jason Gleason:It's been years since uh again initially I've done this. Um, but I would say licensure is a big deal, board certification, those kind of things, those documents. Um what do you think?
Christopher Gleason:I think keeping I mean, even though you even if you're in the same job, I think keeping your CV up to date is important because especially if you're doing anything outside of outside of the the um place you're working for. I mean, if you're doing any sort of extracurricular activities, things like that, I think that's important to keep the CV up to date. And it's often time something that they'll ask for again. So yeah.
Vanessa Pomarico:And Chris, you make a great point, keeping it up to date. Whenever I give a talk or a presentation or I'm at a conference, the first thing I do is update my CV. Because if you ask me a year from now what I've done, I'm not gonna remember it. So I always tell people keep a running, a running list of all of your accomplishments so that this way you can really make yourself shine.
Jason Gleason:Absolutely.
Vanessa Pomarico:Great, great questions. All right, so here's our landing checklist. We have three take-home tips for your tool belt. So you want to enroll in the CAQH. We've talked at this uh many, many times. Assemble your verification folder, keep things organized. And as you just mentioned, Jason and Christopher, answer those credentialing emails within 24 hours and keep a running verification log. So here's your homework for the week. You want to create a credentialing folder and complete it or update it, the CAQH this week. So I have I have one more thing for you to do here is the five-star launch. We want to make sure that you are enjoying our podcast. So please make sure that you drop us the five stars, hit follow, tap subscribe, and share this with another nurse practitioner who might need some of this information or some solid um guidance on how to navigate that process of credentialing and privileging. So, do either one of you have anything else you want to add before we wrap this up?
Jason Gleason:You know, so much of this is overwhelming. I think some of our friends and colleagues out there are thinking, wow, this is a lot to take in, right, during this podcast episode. And it is. There's a lot here, and it's important stuff. It's the foundation for your entire practice and your career, right? In many ways. So I'd say don't be overwhelmed by this. You know, take all the tips that we we've recommended to you. Don't be overwhelmed by it, but stay on track and uh and make sure you get it done. But stay organized, stay organized, but but take it easy on yourself too.
Christopher Gleason:And just remember you have these show notes to look back on. So you have this these as a point of reference. You have all the the you know, our tips and tricks, but you also have the the websites that are available to you and um all of those different resources available to you.
Vanessa Pomarico:Great, great points, guys. Thank you so much. All right, so that's a wrap on this week's episode of NP Launchpad. Thank you again for joining us. And make sure you tune in for our next episode drop on those first 90 days of being a nurse practitioner. Thanks, everyone.
Voiceover:You've been listening to NP Launchpad, presented by Fitzgerald Health Education Associates. Like, subscribe, and share. And for more tools to power your NP career, visit FHEA.com.
