Medical management companies exactly how important and how big the impact provider credentialing have on the cash flow to medical organizations. It is extremely hard for most people to understand, no less managing credentialing for organizations. Medical services credentialing is tedious, time-consuming, and can consume company staff resources and much of the budget. It is so tedious and time-consuming because most practices lack expertise in the credentialing areas as it is not a function that is typically performed in a medical practice. Most practices also lack the necessary tools to manage the credentialing process which leads to measures that are enacted when claims begin to get denied due to network issues. Because of increased government regulations, payer requirements, and lack of industry standardization, the credentialing process is completely predisposed to pitfalls.
There are several medical credentialing services that make it easier for each practice when it comes to their unique requirements for their credentials. Credentialing services create customized solutions to consult, supplement, and provide fully credentialing management services for medical providers. Their customized credentialing services include management and oversight services, initial hire packet and enrollment design, provider enrollment assessment, maintenance and updates for CAQH, Medicare, and Medicaid enrollment process services, and out of state payer enrollment services. Customized credentialing services also include “change-to” address services and facility address update/change of services.
New providers often have a frustrating time with their credentialing processes because of the amount of time and the sheer number of requests they have from the staff that is inexperienced with credentialing and unable to do it quickly and properly. The continual frustration and headache because of their lack of experience of not knowing what payers will request and not know how to fill out credentialing applications. This makes it take an incredible amount of time for providers to get credentialed.
Credentialing services make it easier for providers by facilitating the required information and documents needed to give providers credentials as fast as possible. When the providers fill out an enrollment package, they give the credentialing services company almost all the information they need to fill out their payer applications and submitting them to the payer which eliminates time and headache for the provider.
There are several ways to reduce the amount of time it takes for providers to get their credentials. First off, it is smart to start the application process as fast as possible so that credentialing can be finished within 90 days more often than not. the next step is to review all of your information that you put on your provider application. Make sure all the details are correct, all licenses are clear, and paperwork is legible. Also, make sure to stay current as a provider on expiration dates, board certifications, CME hours and more.
Having your practice credentials managed by credentialing services saves your practice time and confusion. When experts in credentials take over, it saves the hassle of trying to figure it out yourself and having your practice make mistakes.