The process used by customers to evaluate the qualifications and history of a provider is known as physician credentialing. Physicians are required to verify their credentials such as education, training, residency, licenses, malpractice coverage, clinical judgment, and other certifications they may hold.
In order to verify these items, data collection, source verification, and committee review are all involved. This is an extremely important process for both patients and providers to ensure that patients are safe and allows practices to receive proper reimbursements for their services. By simplifying your credentialing process, your denial management will also benefit, as all practitioners will be verified and ready for reimbursement processing.
Obstacles Faced in Physician Credentialing
1. Errors within Applications
2. Lack of Organization
3. State Compliance
4. Outdated Physician Information
How To Simplify Physician Credentialing
1. Be Timely in Your Credentialing Process
It is wise to start your credentialing process as soon as possible, as the process can be lengthy, even when done correctly. This process can take 90 to 150 days from start to finish so staying on top of your applications is extremely important.
2. Make the Most out of Your Technology
By utilizing one of the many credentialing platforms available, your practice can stay efficient in the credentialing process. When relying solely on manual applications, there is room for human errors which can delay the entire process and your practice will lose out on revenue.
3. Ensure All Information is up to Date
Having updated addresses, phone numbers, CVs, certifications, and other practitioner information is vital to simplify credentialing. Education and work history must be accurate, but it is also imperative to have details such as privileged facilities, contract groups, and any leadership or teaching positions held. To ensure these details are accurate before submission, practices can also conduct background screenings to verify the information provided.
4. Verify State Regulations
Laws surrounding the credentialing process differ from state to state and can change quickly so it is important to stay on top of any new or current regulations and update your systems accordingly. Without following this step, you may experience hiccups along the way which will hinder the credentialing process.
Let Us Help You Transform Your Medical Practice
Here at Credence Global Solutions, our team of experts is ready to assist you in your healthcare facility. By providing top-of-the-line service as well as the most up-to-date technology, you can be sure that your practice is in the best of hands to get the most out of your revenue cycle management. Contact us today to learn more!
