How to Streamline Physician Credentialing Process?

By medisys Medical Billing Services 0 Comments

In healthcare, Physician Credentialing is the key process of organizing and verifying a doctor’s professional records. Every physician have to be credentialed with payers to get reimbursement for patients with insurance. We submit credentialing application within 7 days or as soon as we receive CAQH and required documents from physicians. Generally standard credentialing process takes from 90 to 120 days based on the payers’ guidelines. Keeping in mind that the complexities in medical credentialing, it is good to streamline physician credentialing process.

With all of this complexity, creating a streamlined credentialing process to protect your practice and make sure that your staff is properly certified becomes an essential. A weak or ineffective credentialing process can effect severe problems for your practice. If mistakes happen, or credentialing lapses, you may face stoppage of provider services, accreditation issues.

A well-trained and experienced physician can render high-quality services and to attest his/her merit, provider credentialing is necessary. Physician credentialing is a process through which Providers are validated for their educational qualification, certification, work history, and conduct. To run the operations successfully, every provider streamline their physician credentialing processes. Here is how they can do it:

Accurateness

It is highly recommended that the data entered in a medical billing company’s provider credentialing system matches with the data added into the payer’s credentialing system. A small mistake may cause revenue loss to provider. Therefore, we do a thorough check on our clients (providers) background information before sending any application to payers.

Automate Tasks

To streamline physician credentialing process with automation to make it accurate and faster. As physician credentialing is a time-consuming process, old-fashioned data systems may delay it further. Using automated systems can really improve the physician credentialing process. These systems can automate critical credentialing tasks to remind and request for timely submission of applications.

Follow-up

It’s a good practice to keep follow up with insurance companies once the provider credentialing process starts. Stay in the loop and follow up on regular time intervals will keep us informed on status of the application.

Application Tracking and Reporting

Implementing best practices will definitely improve physician credentialing process. Keeping a track on the provider enrolment days, provider processing time and multiple payers’ rules set is important. Provider must have weekly or monthly reports with the tracked data for review status of credentialing.

Outsource Physician Credentialing Process

Many times physicians struggle with doing credentialing themselves. They must try and find best medical billing company to outsource physician credentialing process. MedisysData follow streamlined physician credentialing process which result into faster turn-around times and better revenue generation at low costs. We are equipped with qualified and certified credentialing experts to enhance the physician credentialing process.