MAKING THE CREDENTIALING AND PROVIDER ENROLLMENT PROCESS EASIER

While there’s no way around completing all of the paperwork and proper submissions, there are a number of ways that your healthcare organization can simplify the process.

Requiring a Strict Deadline on Physician Information. It’s important that organizations set a standard time frame for physicians to supply all of their information to support the process. That time frame should allow ample time for the process to be completed prior to the physician’s start date with the organization.

Verifying All Information- Prior to sending the application, it’s important that all information is verified. The most common reasons that applications are denied is due to insufficient or outdated information.

Using Current Technology- Working with outdated technology can hinder the process. If your credentialing software or system doesn’t match the provider’s, there should be a seamless way to transfer the data without incurring mistakes. It’s not ideal to require manual input because that results in higher errors which can impede progress.

Taking Care With Vendor Selection- If your organization has opted to outsource the credentialing and provider enrollment duties to a vendor, it’s important to verify their track record with insurers and their receptiveness to meeting your practice needs through excellent customer service.

Staying Up to Date on Regulations- Regardless of the choice to use a vendor, in-house software, or cloud-based technology, it’s important that current regulations are met. This means actively refreshing knowledge to any changes in regulations.

While medical credentialing and provider enrollment does need to be handled in a precise manner, that doesn’t mean that it needs to be overly complicated. Healthcare organizations should seek to develop an organized protocol to submit applications and complete the process, limiting human error and diminishing wait times.