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Why to outsource your medical credentialing and enrollment process?

As you all know, healthcare establishments exist to facilitate and administer medical care to their patients. While today we do have advanced like never before in our cure techniques, infection prevention, disease management, and nearly every other available metric, the obstructions to actually running a prosperous practice have done nothing but increase in size.

Every medical facility/practice, irrespective of its size, is faced with a daily barrage of challenges that aim to prevent or limit the practice’s payment for services. Within the revenue cycle management, medical credentialing and insurance enrollment denote the first obstacle in obtaining timely payments. As you must be aware, insurance credentialing or provider enrollment has developed over the years to be one of the most complicated and confusing processes within the healthcare industry. 

Here are some vital tasks that will motivate you to outsource the medical credentialing and enrollment to a professional medical billing and coding organization.

Specialized services covered 

Some function in the healthcare facility requires unique training and skill sets and that is where outsourcing comes into play.  Tasks such as IT management typically are at the forefront of this category because not all practices, especially small facilities can’t afford a full time IT person. 

Credentialing falls into this group as it is a unique service requiring someone with expert knowledge of the processes in order to successfully maintain your medical credentials with hospitals, insurance plans, and other healthcare organizations that require credentialing of your providers.  Handled haphazardly can have a dramatic impact on your revenue cycle.

Repetitive work

The repetitive nature of completing insurance credentialing and enrollment for physicians along with the follow-up necessary to complete the process with payers further makes this function a prime candidate for outsourcing.  The daily tasks of maintaining documents, keeping patient profiles up to date, and ongoing monitoring of credentials are time consuming tasks, which should best left to someone with automation and specific focus on these duties.  

Requires expertise in the job

Hiring medical billing and coding experts in a business role that is outside of your core work area is often a good call considering those services best suited for outsourcing.  Practices that are centered on providing professional healthcare services need not recruit, retain, and manage experts in credentialing.  They can directly outsource these undertakings to partners whose core competency and business is credentialing.  The credentialing experts can help you shore up your revenue cycle management by making sure your providers are enrolled with health plans in a timely manner.

Keep in mind that medical credentialing and enrollment is fit for outsourcing. Any healthcare facility should evaluate outsourcing this function to a business partner whose core business function is credentialing and enrollment.

About Medisys

We are a group of medical billing experts who offer comprehensive billing and coding services to doctors, physicians & hospitals. We provide end to end billing and coding solutions. Medisys Data Solutions RCM solutions ensures that the providers recover every $ they are entitled to. Our vision for the providers is “You Cure. We $ecure.”

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