Credentialing nightmares

The credentialing process, notorious for its red tape and endless paperwork, can be a literal nightmare for private practices. Regardless of size or type of the practice, the stories I have heard from many are all similar: staff spending hours upon hours poring over intricate paperwork, overwhelmed by the threat of an incorrectly submitted and processed application. While there is no way around it, credentialing is an absolute necessity for billing purposes, legal protection, and the safety of patients – we frequently hear from practice managers who say the process is the most tedious and thankless part of their job.

The threat of negligent credentialing looms over physician’s practices for good reason: in one reported case, a practice faced legal action from a patient injured during treatment. The physician hadn’t been properly credentialed for a particular procedure, and when the patient suffered complications following the procedure, he sued the practice for negligence, leading to a major financial blow to the practice. In a busy practice, it’s easy to overlook the fact that a physician’s paperwork might be out of date. The constant follow-up needed to keep a practice in good standing is incredibly time-consuming, but in a worst-case-scenario, a lapse in diligence could mean the closing of the practice.

While many practices want to maintain ownership of and control over the process, I’ve never met anyone who hasn’t been head-over-heels pleased with the dependable, consistent results and value that outsourcing of credentialing has brought to their practice. ClinicSpectrum’s credentialing services provide 24/7 review and verification of a healthcare provider’s professional license(s), current Drug Enforcement Administration and Controlled Drug Substance Certificates, verification of education, post-graduate training, hospital staff privileges and levels of liability insurance. Once we have confirmed that a provider is up-to-date with their preferred health plans, we provide ongoing support to ensure that a physician is always in good standing.

End the nightmare. It’s easy. This added layer of consistent follow-up, including bi-weekly status reports to all of our customers, allows physicians and office staff to focus on the patients rather than the paperwork.

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