The most meticulous administrative task that requires painstaking specifications in a healthcare setup, is physician credentialing. This process directly affects reimbursements. The verification process of a physician can take anywhere between 90-120 days also with the restriction of not be enrolled in any health plan which results in non- reimbursement to the hospital or practice in spite of their work. Not only that, but the claims are either put on hold or not recorded. This is not a good sign for the practitioner or the organization. Many challenges make the credentialing process difficult but in spite of that healthcare, units make sure that their physicians get credentialed on time without any fuss.
Here are four important checklists for credentialing –
- Provider Application – This is the first and foremost step in the credentialing process. You have to track your provider’s personal information and their practice history. It is really important to check the necessary information regarding the provider’s professional credential, experience and where they practice. After that, you must ensure that they answer a series of questions that they answer adhering to their professional conduct.
- Several legalities kept in check – When it comes to credentialing there are numerous requirements of accredited setups which varies from state to state. Keeping the record of what needs to be collected or submitted an in what type can be an exhausting task. So outsourcing it to the third-party vendor is the wise step as they will handle all the credentialing services for you.
- Seeking to peers for references – In the credentialing process, peer references are one of the priorities. Those review documents are quite difficult to attain from the physicians whose reference you are seeking because of their jam-packed schedule. To make this documenting process favorable you must ensure that your documents are completed before approaching them to avoid any disagreements and quick results.
- Maintaining the timeline of evaluations – As a medical practitioner or another healthcare provider, you must be aware of the initial medical credentialing which has to be re-credentialed every 2-3 years which also depends on the factors like in which state you live and the policy of your payers. It’s quite a magnanimous task, but a necessary one, as it’s required before a healthcare organization or practice can create the bill on your behalf.
The road to credentialing is a time consuming process and so 24/7 Medical Billing Services offers assistance and saves your precious and productive time so that you can utilize your time for in-house tasks. Make yourself assured with our 24/7 services as we are consistent with our credentialing services every day.