Credentialing lays the foundation for a clinic’s relationship with insurance firms as well as patients. It’s the base of starting and running any successful healthcare practice.
Insurance credentialing is the process that connects you and your practice with insurance providers to enable you to receive payments from them. The process can affiliate you to several insurance firms, which in turn allows your facility to cater to a more significant number of patients and also forge relationships with the individual insurance companies.
It’s only a few years ago that practitioners considered medical credentialing to be an optional step in developing their clinics, or an unnecessary move to building their patient/client caseloads. During those times, it wasn’t an expectation that a facility should accept insurance – some issues like mental health weren’t even featured in these insurance plans. Besides, the clients could meet a practitioner of their choice and then file for compensation from their insurance provider later on.
Today, more than ever, it’s vital for a healthcare provider (whether its psychologists, chiropractors, professional counselors, nurses and more) to be in network with insurance firms. Credentialing has become a necessity because more and more people in the US are taking insurance cover. It’s also a necessity because patients today want their caregivers to accept insurance. To cut to the chase, if your practice isn’t credentialed with the insurance plan of your potential clients, then you’re at risk of losing them to a competing healthcare provider.
Although insurance credentialing is crucial to the success of a medical practice, getting enrolled on insurance panels isn’t always the easiest option. These applications can be more than 30 pages long and is coupled by plenty of time-consuming follow-ups.
Since it’s a very meticulous process, many practices depend on credentialing software to help make the process simple, efficient and productive. The software creates safe and easy access for multiple authorized users on different platforms. Besides, it allows for integration with other programs, as well as personalization to suit the requirements of individual facilities.
The best part is, the credentialing software can implement an automated system, decreasing the likelihood of mistakes within your practice. You may also use the software to manage meetings, as well as follow-up discussions with less time wasted. It allows for remote meetings, cutting out the need to move from one place to another, and using papers too.
But even with the credentialing software, it can be difficult for a medical professional to keep up with the process. As a practitioner, your primary focus is treating patients, and maybe once in a while, you attend meetings. Trying to muddle between all these duties can be tiring, and mistakes are prone to happen. Unfortunately, a single credentialing mistake can cost your practice thousands of dollars in legal fees or negatively affect your good standings with patients leading to medical board reviews. If you think you’ll have trouble managing all these, then it’s better to outsource your medical credentialing services.
Medical credentialing services providers exist to take the hassle out of getting provider enrollment. They are well-connected and have the right resources to ensure you’re in a network with insurance panels.