Clinical Billing - War Of The Worlds
The Problem With Credentialing Medical Sales Reps
Is medical sales rep credentialing making you crazy? Medical sales reps who call on hospitals must provide a range of documentation in order to gain access to their customers. The lack of a universal credentialing process costs medical device companies and their reps both time and money. These costs are ultimately transferred back into the products - adding an estimated $1.7 billion to the cost of healthcare each year.
The Credentialing Concerns of Medical Sales Reps
Slip on a pair of green scrubs and most people will assume you belong in a hospital. But medical sales reps know it takes a lot more than scrubs to gain access to your customers at the hospitals where they work. They must have the right credentials.
Every hospital has certain requirements of its vendors and their representatives. Depending on the areas of the hospital medical sales reps need to access, they may be asked to provide their immunization records, submit to a background check, show proof of product and/or liability insurance, and undergo training in OR protocol, blood-borne pathogens, and the Health Information Patient Privacy Act (HIPPA). Depending on the facility, other training and documentation may be required.
Most people understand why hospitals require this type of information from reps when entering their ORs and other patient care areas; the requirements are safety measures put in place to protect the patients, and no one has a problem with that. No, the problem with the current medical sales rep credentialing process lies in:
1) the lack of uniformity in hospitals’ requirements, and
2) the repetitive costs associated with multiple vendor credentialing companies.
These issues cost the medical company and its reps both time and money - adding an estimated $1.7 billion to the cost of healthcare each year, according to the Independent Medical Manufacturers Distributors Association.
Several years ago, a group of organizations attempted to address the first problem by issuing a Joint Best Practices Recommendation for Clinical Health Care Industry Representatives (HCIRs). Led by organizations like the Advanced Medical Technology Association (AdvaMed) and the Association of peri-Operative Registered Nurses (AORN), this group suggested hospitals focus on the following credentialing criteria:
Health Vaccinations
Product and/or General Liability Insurance
Background Verification
Hospital Unit Orientation/Policies and Procedures
Training Documentation
Much of the industry is assimilating around these recommendations, but there are still no uniform requirements. Each facility ultimately determines their own credentialing policy, and many then look to a credentialing company to help them enforce it. Medical sales reps must provide the necessary documents to the credentialing company associated with each hospital they call on. This leads to the second major problem mentioned above - the repetitive costs associated with this process. Each credentialing company charges a fee, sometimes on a per-hospital basis.
“Independent sales reps or reps working for smaller firms are expected to pay their own credentialing costs,” explains Charlie Higgins, executive director of the Healthcare Manufacturers Management Council (HMMC) and the Health Industry Representatives Association (HIRA). “Larger companies traditionally pay the fees on behalf of their reps, but it’s extremely costly and that expense is ultimately transferred back into the products. Independent reps must simply absorb the cost.”
Higgins and the organizations he represents support the Joint Best Practices Recommendations for Credentialing Clinical HCIRs. Higgins also stresses the need for a central repository to house the credentials of all sales reps. Hospitals or their credentialing companies could easily access this database to view a universally accepted set of credentials, thus removing the need for reps billing for mental health services to provide the documentation multiple times.
Higgins envisions a type of license or passport that reps could acquire once they provide the necessary credentials to this central database. The license would grant them access to any facility. “It’s not that companies and reps don’t want to cooperate,” says Higgins. “But for the sake of everyone involved, the process needs to be simplified.”
For now, the process remains both costly and inefficient - but why? Some speculate that the complex requirements of hospitals are put in place to deter medical sales reps. They argue if patient safety was the only motivation, hospitals would require similar documentation from everyone visiting relatives in the ICU or all service technicians working in the facility. Another theory is that hospitals doing their own credentialing are motivated by revenue. Others suspect hospitals receive a portion of the fees collected by their vendor credentialing companies. Of course, reps making these types of groundless accusations come across as angry and combative, and their resistance will not win them any friends inside the hospital.
While the current system may be frustrating (and expensive), medical sales reps have no option but to comply. But given the chance, what solution would you propose? Or maybe you’re happy with the current system. Please share your thoughts on the credentialing of medical sales reps in the comments below.
