The prime motive of every physician is to provide un-compromised medical services to his/her patients. It is based on the quality of the services that patients decide whether to visit the same physician or change for good.
Only a well-trained and experienced physician can render high-quality services and to attest his/her merit, provider credentialing is necessary. Physician credentialing is a process through which Providers are validated for their educational qualification, certification, work history, and conduct. It is done every time a medical practitioner joins a hospital. Also, re-credentialing is performed each year. There is yet another process called privileging through which a physician is authorized to render a certain scope of clinical service based on his/her credentials. All these processes are complicated and consume too much time, affecting the normal functioning of medical billing companies and their revenue cycle. To run the operations successfully, all medical billing companies should streamline their physician credentialing processes. Here is how they can do it:
Accuracy is Key: It is highly essential that the data entered in a medical billing company’s provider credentialing system matches the data entered into the Payer’s credentialing system. If there is a mismatch, the revenue will eventually get affected. Therefore, do a thorough check on the Provider’s background information before entering into the physician credentialing system.
Use Cloud-based Platform: Documenting Provider information is essential and real-time data is the best bet. To enable it, medical billing companies should integrate their systems with a cloud-based platform for efficient provider credentialing. This way, documenting, accessing, and sharing data will be easier. Constant reviewing and updating data into the cloud systems is crucial to avoid errors during submission.
Enhance Operations through Automations: As physician credentialing is a time-consuming process, traditional data systems will only delay it further. Using high-end automated systems can really enhance the process. These systems automate critical credentialing tasks to send reminders and requests for timely submission of applications or reviewing of red flags.
Follow-up: It is a good practice to keep tabs on insurance companies once the provider credentialing process starts.By staying in the loop and following up on regular time intervals will let you know the status of the application as well as hasten the process. Meeting every Payer’s individual set of rules and regulations is essential.
Tracking & Reporting: Implementing best practices will improve the physician credentialing process. One of them is tracking and reporting. Keeping a track on the provider enrollment days, department & provider processing times, and multiple payers’ rules set is essential. The staff must submit weekly or monthly reports with the tracked data to the higher authorities for review. Necessary steps should be taken if there are areas of improvement.
Outsourcing: Most medical billing companies are preoccupied with major medical billing functions, overlooking provider credentialing. Therefore, they lack the aforementioned streamlining properties. In that case, outsourcing would be the best bet. Offshore medical billing companies are equipped with high-end data systems and cloud-based software to enhance the physician credentialing process. They also come with experienced professionals who are adept in rendering error-free credentialing. Last but not least, they ensure faster turn-around times and better revenue generation at low costs.
About e-care India:
If you are on the lookout for a good offshore medical billing company, then choose e-care India. This experienced vendor has been serving exceptional medical billing services including quality provider credentialing services for more than 18 years. It prepares, maintains, and monitors Managed Care summaries. E-care resolves enrollment issues and track Managed Care contracts more effectively than the other leading offshore companies in the industry. To know more about e-care and its services, log on to www.ecareindia.com.