When Does Outsourcing Your Credentialing Make Sense?

medical credentialing services

Everybody knows, healthcare facilities exist to facilitate and administer medical care to their patients. Though these healthcare facilities have advanced tremendously in minimizing cure rates, preventing infectious diseases, enhancing disease control, boosting operating room efficiency, still the roadblocks in running a successful practice are always ever-increasing.

Every practice, regardless of its size and volume, faces a barrage of challenges every second day that aim to limit its recovery of payments.
The top reasons for that cause are revenue cycle, physician credentialing and insurance enrollment and that is exactly what we’ll discuss in this article.

Insurance credentialing and enrollment has evolved into a highly complex process in the past few years, and a regular practice cannot easily get its way through it unless it has an expert on board.

Therefore, we will discuss the best ways to cope with this situation and how to improve the revenue cycle and bring more profit to the practice.
How to improve revenue cycle of healthcare practice?

The best way is to outsource the insurance enrollment and credentialing service. Many of us are afraid of outsourcing insurance enrollment and credentialing that the benefits of doing so are far more.
Reasons include:

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1. More efficiency, less rejection

It is true that in-house staff should handle financial work, but that is certainly not possible when there is too much at hand. The official team tasked to handle insurance enrollment, and credentialing will also be involved in other tasks.

And there are a higher number of chances that those other services are given more priority due to their immediate need. This can lead to a lag in insurance credentialing and thus, results in more errors. However, as part of the reputed medical practice, you should know that medical practices can get bankrupt by slight missteps in the credentialing process.

It has happened many times in our years of service, and most of the common reasons are the lack of medical revalidation and re-credentialing that results in deactivation of PTANs or that the re-credentialing requests are tossed away resulting in termination of contracts.

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2. Save time, Reduces labor

When you, as a practice, apply for the medical insurance enrollment or re-credentialing, you will have to go through some processes and will have to seek confirmation from a dozen of checkpoints.

This doesn’t happen when you hire a professional insurance enrollment person for the job. They are experienced and during their job, made good relations with most of the credentialing experts. Thus they can bypass most of the customer service departments and shave off at max 30 days from the credentialing process. This results in the timely submission of the application forms.

Moreover, these experts ensure that correct forms are used for the credentialing and that the addresses and emails are correct.

3. Eliminate the risk of turnover

Let’s be honest about turnovers. They can happen at any time and no organization in the world, how successful it may be, can control the outcome. But, it can prepare for it.

We have had turnovers in our organization, and we tackled them. That’s why we know, how crucial the management’s role is during the whole process.

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This also means that no accounts should remain unchecked and proper credentialing with each insurance company should be done on a timely basis.

Physicians can do this work but do they have the time to do it? They are busy in dealing with patients, and work like this needs a financial eye. There is a high chance while filling these details, and the physicians may miss some essential information.

That’s where the expert’s help is needed. However, an outsourcing insurance enrollment and credentialing service can get it done seamlessly.

On an average, , Credentialing Services for Physicians can take around 180 days to complete, but our credentialing service can get it done in less than four months.

If finishing the whole process faster and accurately is important to you, then put your trust in us.


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