What are the Challenges Involved in Physician Credentialing?
Added: (Sat May 04 2019)
Pressbox (Press Release) -
Medical credentialing is a complex process that requires specialists for effective execution. Only an expert can track re-attestation and revalidation updates and complete the process from start to finish. At times, physicians ignore the early warning signs of the process. They also ignore the fact that credentialing is a legal process that can lead to heavy penalties, if not handled carefully. Therefore, hiring medical credentialing specialists is the right course of action.
Here are some of the challenges of credentialing that only a specialist can help you avoid:
• Credentialing is a time consuming procedure and takes around 60 to 90 days for fully credentialing a new provider. This process needs to be completed before the provider can take up new patients. Since there is a lot of verification involved related to education, training, employment history and licensure, one minor mistake can delay the process further.
• Securing peer references is a struggle in credentialing since every physician has a busy schedule and has to manage several responsibilities. To solve this issue, it is required by physicians to notify their peers that a request would be coming and to propose a timeframe for completing the same.
• It is a daunting task to keep physicians up-to-date. For instance, in ambulatory surgical centers, practicing physicians need to have their credentials reevaluated every 1 to 3 years. This turns into a complicated act for the ASCs as all physicians have different timelines for reevaluation.
• With the addition of new state exchange and federal plans, credentialing has become more challenging because now physician practices have to stay on top of plans that their patients are joining. Also, practices need to balance the rise in number of patients and the corresponding revenue generated from those patients.
• Under medical credentialing, it is very important to have the right strategies in place or else the physician will not get paid in a timely manner. For instance, if the physician isn’t enrolled with their patient’s exchange plan, they might not get paid for the rendered services.
Considering the complexities involved, many practices choose to outsource credentialing procedure to a third party. They prefer hiring a specialist for this job because physician credentialing and insurance enrolment represent the first obstacle in getting paid in a timely manner. With efficient credentialing, practices can improve their revenue cycle and become more profitable.
About 247 Medical Billing Services:
We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses.
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