March 2006
  The Actual Cost Of Responding to Affiliation Request Letters
Latest Features of PHDB
Participating Hospitals
This Month's FAQ

Latest Participating Hospitals

Aurora Bay Care Medical CenterGreen BayWI
Aurora Health Center-Fond du LacFond du LacWI
Aurora Health Center-OshkoshOshkoshWI
Aurora Lakeland Medical CenterElkhornWI
Aurora Medical Center - HartfordHartfordWI
Aurora Medical Center - KenoshaKenoshaWI
Aurora Medical Center - OshkoshOshkoshWI
Aurora Medical Center-Manitowoc CountyTwo RiversWI
Aurora Psychiatric HospitalWauwatosaWI
Aurora Sheboygan Memorial Medical CenterSheboyganWI
Aurora Sinai Medical CenterMilwaukeeWI
Barton Memorial HospitalS Lake TahoeCA
Bayshore Medical CenterPasadenaTX
Chandler Regional HospitalChandlerAZ
Community HospitalMcCookNE
Dameron Hospital AssociationStocktonCA
Denton Regional Medical CenterDentonTX
Duke Health Raleigh HospitalRaleighNC
Enloe Medical CenterChicoCA
Florida Hospital Memorial System - OrmondOrmond BeachFL
Franklin Regional Medical CenterLouisburgNC
Indian River Memorial HospitalVero BeachFL
John Umstead HospitalButnerNC
Johnston Memorial HospitalSmithfieldNC
Lodi Outpatient Surgical CenterLodiCA
Marshall Medical CenterPlacervilleCA
Maryvale HospitalPhoenixAZ
Memorial HospitalColorado SpringsCO
Memorial Hospital of BurlingtonBurlingtonWI
Mesa General HospitalMesaAZ
Nemours Foundation: Alfred I duPont Hospital for Children and/or Nemours Children's Clinic-WilmingtonWilmingtonDE
NorthEast Medical CenterConcordNC
Nyack HospitalNyackNY
REX HealthcareRaleighNC
Santa Clara Valley Medical CenterSan Jose CA
Scenic Mountain Medical CenterBig SpringTX
Select Specialty HospitalMilwaukeeWI
St. Joseph's Medical Center of StocktonStocktonCA
St. Luke's Medical CenterMilwaukeeWI
Straub Clinic & HospitalHonoluluHI
The Bloomsburg HospitalBloomsburgPA
The Westerly HospitalWesterlyRI
WakeMed Cary HospitalRaleighNC
WakeMed Raleigh CampusRaleighNC
Wayne Memorial HospitalGoldsboroNC
West Allis Memorial HospitalWest AllisWI



The Actual Cost Of Responding to Affiliation Request Letters
By Maureen Caburis, Medical Staff Coordinator, Chandler Regional Hospital

You know the drill. Everyday, another batch of letters arrive from hospitals, health plans, or some other healthcare organization wanting to verify the status of one of your medical or allied health staff. Everyday, there is always something more pressing than answering those letters and second requests and the stack gets bigger. What costs do we really bear to respond to this unending process?

While there are many schools of thought on how to actually calculate the cost of responding to a single affiliation letter, there is limited available documented statistics for the medical staff and credentialing industry. In an annual study conducted by Dartnell’s Institute of Business Research, the average cost of producing and mailing one business letter is $19.92! Even with the recent postage increase to $.39, the biggest expense is time for a person to create and manually handle the letter. Depending on the quality of your letterhead and envelope, stationary can add significant costs.

The Director of a CVO for a large 14-hospital system conducted their own study and calculated that they spent an average of 15 minutes to respond to each affiliation request letter. This included the handling of the letter (opening and reading), researching the practitioner’s information, producing the response letter from a credentialing system, folding/stuffing the envelope, and mailing. In such a high volume environment with thousands of practitioners, the 15-minute estimate is probably among the most efficient. In a lower volume hospital, the time per letter could be greater because there is less benefit from economies of scale. If the average hourly cost of a medical staff professional is $20/hr including benefits that would put the cost of responding to an affiliation letter between $5 and $6 including postage and letterhead. In a situation where a medical staff professional receives 100 letters per month, that would be a $600 monthly cost. Using the study from Dartnell, that would almost be $2,000 a month!

The Practitioner Hospital Data Bank has created an ingenious solution. The PHDB is a secure on-line data bank which hospital medical staffs can upload their roster of medical staff in good standing. They direct querying entities to print their letter directly from the PHDB, completely eliminating the need to handle and create responses to affiliation letters. Not only does it save them $5 to $19.92 per letter (depending on which study you use), but more importantly, they are improving their service to querying entities and saving them time and money by not needing to generate/mail the letter in the first place. Because the PHDB is centralized, a single login and password gives a user access to multiple hospitals’ medical staff information.

The PHDB has created a truly effective technology solution to a costly function within the medical staff office. While your time requirements to respond to an affiliation letter may not be the same as above, there’s no disagreement among MSPs that an automated solution like the PHDB can only benefit our industry as a whole by reducing costs, expediting the credentialing process, and freeing up more time to focus on more important issues than shuffling paper. You can check out their user-friendly website at

Maureen Caburis is the Medical Staff Coordinator at Chandler Regional Medical Center in Chandler, Arizona, a Catholic Healthcare West healthcare facility.

Latest Features

New Feature for Practitioners with multiple "on-staff" dates:
A new feature of the PHDB will now handle Practitioners that have multiple "on-staff" dates at your facility. This is especially useful for Locum Tenens and Radiologists. Now you can submit several rows of information with differing dates on staff, departments, and status for the same practitioner and have them show up ont he same letter. You can simply include this information in your batch up date and our system will do the rest.

If you would like additional information or have any questions please email us at or call us at 800-995-4233 ext 206.

This Month's Frequently Asked Question

How can the PHDB protect my hospital from letter forgery?
With today's advanced computer software, it can be easy for someone to forge an affiliation letter on your letterhead. This could potentially expose your hospital to medical liability. With the PHDB, you are protected from this kind of fraud and forgery because we assign every query a unique PHDB Confirmation Number and this number is printed on the letter itself. If any questions arose regarding this practitioner, we have a complete audit trail of who requested the query and when it was performed.

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