Credentialing is not only a good practice but also imperative if you are going to recruit the best physicians into a practice. If the process of credentialing is done carelessly, or passively then a few important details could be missed about the particular physician in question. When the process of credentialing is skipped, then it could spell doom for your practice by causing cash flow issues, scheduling hurdles and in extreme cases, putting the well-being of patients at risk. Some healthcare establishments like to carry out their own credentialing through their own in-house experts but most institutions out there prefer the outsourcing route — by seeking medical credentialing services.
Either way, the point is no medical practice wants to have issues with credentialing in order to avoid trouble in the future. So what are some ways that can help reduce problems when it comes to credentialing?
Beginning Early Enough
Give yourself ample time for this exercise. The conventional period is usually 90 days, though you should probably look at 150 days just to make it more thorough. This is because medical practices barely have enough time and resources to expedite the process of going through applications. To add to this, application processing is guided by the timeline of someone else and the fact that different payers have varying timelines. Hence, it calls for a practice to grant itself sufficient leeway.
Be Keen Enough
If you don’t pay enough attention to the applications, then you could end up missing a few gaps in the applicant’s information. Cases of outdated, incomplete, and missing information on applications are common and are commonly seen in the following areas: physician’s work history and current status of work, proof of malpractice insurance, their attestations, and hospital privileges. Taking note of such gaps can save a lot of time in the credentialing process and if the applicant can have the issues sorted out fast enough, and then he or she can be credentialed within 3 months.
Stay up to Date with CAQH
CAQH is an abbreviation for The Coalition of Affordable Quality Healthcare who began their uniform credentialing 15 years ago. Since their program kicked off, it has attracted admirers from all over the country with most medical practices picking it up. Physicians who stay up to date with CAQH find the credentialing process much easier than those who do not.
Linking a Physician’s Start Date
It would be great for the practice if the new physician’s schedule can be filled soon enough. Linking a physician’s paperwork submission dates to their contract is therefore very important.
Complying with State Regulations
Different states have different legislations that govern medical credentialing services. It is therefore important to get in touch with your state medical group association or your medical society in order to ensure that you are practicing within your state’s standard. You also want to observe interstate reciprocity regulations such as a partial credentialing process for physicians changing practices within the same state.