Credentialing Issues and Resolution

Credentialing Issues and ResolutionWhile it’s imperative that each and every physician is properly vetted and credentialed prior to practicing for numerous reasons, the tedium that goes into the process can steal valuable time away from patient care, scheduling and billing – also tasks incredibly important to overall business operations. Compound all of this with the explosion of credentialing requirements and paperwork, staff can take up to 3-5 hours each day on credentialing.

Today’s healthcare industry offers numerous challenges that lend to strapped staff time. Requirements for hospitals and healthcare organizations continue to grow with Meaningful Use and HIPAA. As of January 2013, only credentialed medical assistants have been permitted to enter medication, radiology, and laboratory orders into the EHR to count toward meeting the Meaningful Use thresholds under the Medicare and Medicaid EHR Incentive programs.

With the growing complications and tediousness of credentialing, the risk of error exists, and the ramifications of incorrect or insufficient credentialing can cost practices and hospitals dearly. Payer processes can be slowed, patient-risk is increased and organizations can pay hefty fines in malpractice situations if proper paperwork is not produced.

A resolution? To best manage this oftentimes complicated task of physician credentialing, practices and hospitals can look to vendors well-versed in the space that can securely manage the process for credentialing and re-credentialing. Vendors should have the ability to manage profiles and documents for physicians, help monitor for expiring credentials and have a dedicated, knowledgeable staff to answer any questions about the process in general. Save time, save money, save the legal headaches.

 

Advertisements

A Complete Guide of our Technically Sound Product : CredentialingSpectrum

A complete credentialing profile module for:

  • Management of Credentialing and Re-credentialing activities and reminders
  • Complete Cloud based Documents Management for Credentialing Documents
  • Reminders on Expiration of various credentials such as CDS, DEA, License, CAQH, Board Certification, Mal Practice , Hospital Privileges
  • Facility Credentialing Management
  • Insurance Participation Agreements and/or Contract Management
  • Auto-fax, Auto-email and Secure Messaging Capability
  • Extensive Report and/or analytics Module

A Message Spectrum-A Reliable Automated Messaging module through PHONE / TEXT or SECURE EMAIL

A Reliable Automated Messaging module through PHONE / TEXT or SECURE EMAIL for following issues in Denials and/or need for patient outreach in the areas of,

PCP issues.
Coordination of Benefit issues.
Insurance Inactivity.
Pre-existing condition updates or questionnaire sent to patient’s home.
High Patient Balances.