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    MEDICAL BILLING BLOG

    Avoid Medical Credentialing and Provider Enrollment Delays and Mishaps

    Posted by Carl Mays on Tue, May 21, 2019 @ 10:00 AM

    Competence_in_dictionaryNo enrollment means no payment.

    When a new physician joins your practice, it is of utmost importance for your practice to expedite his or her medical credentialing and enrollment process. Credentialing specialists at ClaimCare can help you do this effectively (doing the right thing) and cost efficiently (doing the thing right).

    Having a fast and reliable medical credentialing process is important.

    As you are probably aware, only after a health plan has awarded your new hire with an "effective date of participation" can this physician’s claims be properly submitted for payment.

    How much are you losing?

    A disrupted cash flow for your practice occurs when an “uncredentialed” physician cannot receive payments for claims while waiting for the practitioner to be enrolled with patients’ health plans.

    According to various reports, approximately $30,000 in lost revenue happens to an average primary care physician with just a month of credentialing delays. This amount increases substantially for higher billing specialties such as cardiothoracic surgery and orthopedics.

    3 reasons to outsource your medical credentialing and enrollment process:

    1. It helps reduce costs while safeguarding stored data.

    Allowing a third party medical credentialing provider to handle the enrollment and credentialing process lowers your expenses. It allows you to utilize top-rated hosting and security technology without the need to pay for the installation, implementation, and maintenance of servers and data encryption software.

    2. It brings better efficiency through robust Key Performance Indicators.

    Third party medical credentialing providers give your practice efficient tracking, trending and reporting data. This includes the following:

    • In-process charges
    • Department processing times
    • Provider process times
    • Days in Enrollment (DIE)
    • Quality measurements for updating payer follow-up notes

    This data allows you to easily establish performance baselines that can help improve your practice. This results in an expedited enrollment and medical credentialing process.

    3. It reduces medical credentialing and provider enrollment errors.

    Third party providers put the credentialing process into a single team that handles the centralized verification office. They are composed of trained, highly skilled, and knowledgeable individuals who are experts in completing your credentialing and enrollment process. This reduces the errors for your practice.

    The bulk credentialing approach of third-party providers also makes it easier for your organization to gain a "delegated status". Once acknowledged, you'll have an even faster enrollment and reimbursement process for your practice.

    So why continue to wait for 60 to 120 days before your credentialing process is completed if it can be done faster and more efficiently? Subscribe to our blog or call us at (855) 376-7631 to learn more about the medical credentialing process.

    About ClaimCare

    Healthcare Tech Outlook named ClaimCare as one of the nation’s “Top 10 Medical Billing Companies” in 2018. This honor follows previous such honors, including being ranked in the “Top 5” by the online magazine, Money & Business. We have a proven track record of increasing client collections by 10 to 20 percent. Talk to us to learn more about our medical credentialing services.

    Tags: medical billing, medical billing services, medical billing resources, credentialing, medical credentialing

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