How to Select Credentialing Software

Whether you’ve done it just once, or hundreds of times, you know that physician credentialing is a labor- and time-intensive task. On the flip side, it’s also mandatory if you want to earn reimbursement from payers while also minimizing risks for your practice. Fortunately, there is a silver lining. Software solutions are available to help manage the process. Here are some key features to look for when selecting physician credentialing software.

Cloud-Based. It’s important to look for a cloud-based solution as opposed to traditional software that must be physically purchased on a disc, manually installed and then maintained. Cloud-based solutions can be easily accessed via a browser, are available on a pay-as-you-go subscription basis, and upgrades can be done quickly and nearly effortlessly from any location.

Automated reminders and alerts. Reminders and alerts are critical to notify users when tasks need to be completed. For example, credentialing software can remind users in advance when physicians require re-credentialing. Alerts help notify of important upcoming dates, such as when physician certifications and licenses are about to expire. These reminders and alerts, combined with reports listing upcoming tasks, help facilitate greater efficiency so organizations can always stay on top workloads.

Convenience features. Credentialing software solutions should also provide numerous other conveniences. Once physician demographic and other information is entered, the system should be able to reuse that information to pre-populate forms and other materials. In other instances, some software can also remove the need for data entry by pre-populating the physician data. Look for a system with import tools that allow for the seamless extraction of provider information from various forms, including insurance company forms and the PDF documents from the Council for Affordable Quality Healthcare (CAQH). Then, once imported, this information can be used auto-populate other forms. This eliminates the lengthy and time consuming process of re-entering information.

Document management. Systems should include document management capabilities to store forms, correspondence, credential verification materials, and more. This saves time by properly organizing documents into a logical order that can be easily navigated for quick reference, and rids office staff of the stacks of folders with hard copies.

With the right software solution, credentialing can be a more streamlined and consistent effort throughout any organization. With the right software, you just might welcome the new staff physician who needs to be credentialed.

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