Provider credentialing is a crucial task that needs sufficient attention from any healthcare provider. It is one of the most important things to get done to ensure smooth management, yet it comes across as a very tiresome job due to a great load of paperwork. It is better to be prepared well in advance in order to avoid any kind of errors, delays or re-submissions. It can be quite a job for a healthcare provider to follow up with this lengthy process while keeping patient care in check.
However if you start early and keep all your papers in ready, it should not be a difficult task for you. Here are some tips on how you should plan your paperwork in order to avoid any issues in the way.
1.Are your papers up to date?
The entire process of provider credentialing is aimed at verifying your educational qualifications, certifications and professional history. So the first thing that you need to do is keep all your files in check and look into them to identify any error or fallacy. The credentialing process starts with asking your name, inquiring about your demographics, your education, certifications to your professional work record. Even any case of malpractice needs to be filed with supporting documents. Credentialing ensures that no unqualified professional is taking care of any patient. That surely will require you to maintain all your current and previous papers properly.
Make a checklist of the documents required and start to keep them in place well in advance. If you are missing any supporting document, make sure you get hold of them to avoid any delay in subsequent processes.
2.Are your documents free from error?
After you have filled out the necessary applications and provided the supporting papers, they will be cross-checked through primary source verification. This process might involve checking with your current employer or even your high school authorities. Any kind of inconsistency found in the process will be directly reported and might lead to cancellation of your application completely.
So make sure you have checked all your papers multiple times to rectify any mistake before filing your application. Most of the provider credentialing applications remain unfinished or take up a very long time to get completed because of the inaccurate papers. If you are ready with your detailed and accurate documentation, your credentialing should not take long at all.
3.Are you aware of your expiration deadlines?
You have to get yourself re-credentialed at least once in every three years. Some of the insurance companies you are affiliated with might also need you to undergo the process once in every two years. As you know, credentialing process takes a while to get completed. You should know your deadline so that you can file for re-credentialing with sufficient time in hand. This will prevent you from going out of network with the insurance companies and guard you against any claim denials.
Even some of your certifications might be needing renewal from time to time and you need to be aware of those dates. If you keep updating your data regularly then the process will be smooth for you. It will prevent you from any claim disputes or denials and keep your revenue cycle management strong.
4.Can you hire a professional to do this work?
Reading through the details, are you feeling that this work is too much for you? Do you feel it will take a significant amount of time from your already packed work schedule? Of course you can hire a professional to do all this work for you!
There are many professional provider credentialing services that help you navigate through this tedious process and make it simpler for you. All you need to do is hire a good credentialing service and provide them with all your documents. They will go through the files and inform you in case any of those papers need revision. They will assist you through the process of insurance reimbursements and ensure that none of your claims are denied.
You might be wondering about the tiresome task of keeping the expiration dates in mind for each of the documents. The professionals will take the responsibility of keeping you updated at all times regarding any deadlines for your certifications. This will help you to maintain your credentials and earn a good reputation with patients and healthcare organizations.
5.Is any automated program available for service?
To take provider credentialing to the next level with near zero errors, top professional services are coming out with dedicated software to do the work. This is an even easier process that you might want to consider if you want to save your time. Increasing number of healthcare providers including hospitals and clinics are gradually shifting to this easy to use method to keep all their credentials in check.
Once you log in all your necessary documents for the first time, the system runs the primary source verification to make sure your papers do not have any error. If any error comes up at that time, you can always review and upload fresh documents. This will ensure that your application does not get into any trouble after the filing is done with the authorities.
The latest software offer a variety of other features like cloud storage, secured access, e-signatures and many more. If you want to take advantage of the latest technology to stay ahead in the field, this could be a good investment for you. The automated programs will eliminate any kind of error caused by human fatigue often faced during manual handling.
Any provider credentialing service will start with keeping your documents in place, whether you do it manually or take the help of a professional. But the constant updating can get tiresome and difficult to maintain for many. You can always reach out to the professionals who are experienced in this domain to ensure that none of the paperwork is out of place and you can carry on with your practice smoothly.
Hope this blog helped you to simplify your credentialing process. For suggestions, shoot your questions below and we will try to answer if relevant to the topic. For more queries and updates on healthcare, please subscribe to our blog.