Credentialing Process
Medical credentialing is so crucial. Credentialing entails a number of submissions and reviews, and when successful, it allows patients to fully rely on their chosen healthcare provider. Even though some people find the credentialing process tedious, electronic credentialing processes offer unparalleled efficiency gains.
Superior Standards
Tens of thousands of Americans die each year as a result of medical errors, which is a sobering statistic. The increased standards of quality and competency that credentialing demonstrates are the reason why industry leaders are so serious and emphatic about them. Additionally, manually processing credentialing applications can occasionally result in even the smallest error, which could have a negative impact on patient safety, a doctor’s professional reputation, and consequently, the reputation of the affiliated institution.
Outsourcing certification
That is why automated credentialing benefits the medical sector so much. A healthcare provider knows they can reduce labor costs and inefficiencies by outsourcing the credentialing process rather than trying to complete everything by hand in the office. All patients can be safer thanks to it, and it can also shield practices from losing money.
We are fully aware of the importance of automated credentialing in any practice. We use that information to develop unique services for practices of any size, such as management and oversight services, Medicare and Medicaid enrollment, and more. Let’s discuss how we can address your credentialing worries so that you can concentrate on your patients.
5 Technology Platforms that Increase Efficiency for Your Medical Practice
It’s not simple to run a medical practice on your own. You have a daily duty to treat sick patients, manage your team, and make choices that will help your financial future. There isn’t much time left in the day after combining it with regular activities like spending time with friends and family or running errands.
However, you still need to schedule time for crucial administrative tasks like practice management and medical billing. You can significantly reduce your risk by implementing high-quality electronic health records (EHR), medical coding, and credentialing services, even though there is no way to completely prevent these and other problems.
Digital Health Records
Medical professionals used to keep their patient records in manila folders in the past. This made planning simple, but it also came with inherent risks, such as the disclosure of sensitive data. With the aid of electronic health record (EHR) software, you can compile and keep track of all your patients’ medical data on a single dashboard.
Although there are numerous EHR platforms available, ours is one of very few that offers fully customizable templates. This implies that you can view and access all of the patient records on a single screen. Through an encrypted and secure patient portal, you can also review and update patient notes, send private messages, and email or text message your patients.
Our EHR also has the following advantages:
- Electronic super bills for prescribing Custom snippets that save time
- Dashboards for meaningful use
- Training and life-saving measures
Computers, laptops, and tablets can all run the program. From the comfort of your home, the exam room, or the operating room, you can access patient information.
Organizational Control over Services
You get access to an annual Service Organization Controls (SOC) report when you subscribe to our EHR software. An extensive audit that assesses the effectiveness of specific delivery services and procedures is known as a SOC report. A SOC can also estimate the likelihood of a future audit.
SOC reports come in three different varieties. You automatically receive an annual SOC audit when you register. This procedure demonstrates our dedication to providing the highest caliber of service and guarantees the financial stability of your practice.
Software for general practice billing
The medical billing industry is what keeps the doors open and the lights on. However, there won’t be much time for processing this information if you regularly meet with patients or go about your daily business. Our medical billing software can be useful.
We offer a practice management and scheduling platform that is completely customizable. Simply log in, complete the patient’s insurance information, and it can quickly determine eligibility. Co-pays and payment collection are simple and hassle-free thanks to the fully integrated merchant service solution that comes with this software. Never before have billing, claims reporting, and submissions been so simple!
Financial Cycle Manager
How well-versed are you in the revenue cycle of your medical practice? Wouldn’t it be convenient to track your weekly or monthly income and evaluate it against previous years or months? To provide thorough insights, our revenue cycle administrator, RCA, uses a reporting platform based on Google Maps.
Utilize this information to boost productivity and revenue at your practice. Making decisions for your staff and the patients under your care becomes easier the more knowledge you have about revenue generation at your medical practice.
Healthcare Analytics at Your Fingertips
Healthcare analytics is another service we offer. For every facet of your practice, this program offers on-demand, real-time data analytics, including:
- Weekly, daily, hourly, and monthly visits
- Peak usage times
- Payment estimates
- Visitation forecasts
- a full payer spectrum
Although the sheer amount of information may seem intimidating, it is for your benefit. Our in-house developed software collects insights about your practice as a whole and transforms that data into useful instructions. When you can distinguish between what works and what doesn’t, you can make changes to your medical practice’s financial operations.
How to Collaborate with a Medical Credentialing Service Logistically
Any practice needs healthcare credentialing. Given the extensive credentials required for proficiency, it is preferable for providers to rely on a company which offers billing, revenue, management, and credentialing in addition to electronic health records.
Outsourced Credentialing’s Logistics
Without the assistance of a third party, credentialing could become a logistical nightmare for your practice. You must continue the process even after the initial certification in addition to making sure every new hire is credentialed. It’s possible for licenses to lapse, training to be neglected, and before you know it, you’re breaking laws and regulations.
Your Medical Credentialing Outsourcing
There are many benefits to outsourcing your credentialing to us. Any type of miscommunication is a risk you can’t afford to take, and malpractice lawsuits and open claims can increase your insurance rates.
Medical certification. Contact us to learn more about why we’re the ideal business partner for your practice. Ting of records and documents, we charge per application and never send an invoice before your application is finished.
Does Your Provider Group Need Delegated Credentialing?
Outside of treating patients, credentialing is one of the most crucial and, in some cases, challenging tasks performed by any medical organization. The right credentialing software can make your daily tasks much easier and enable you to complete them more quickly. As a result, setting up a delegated credentialing agreement is worthwhile for the benefit of your staff, your facility, and the patients under your care.
Collaborating with a centralized credentialing firm
Any entity will want to list each of its individual providers on the health insurer panels when working with a delegated credentialing firm. This is due to the fact that they are qualified for reimbursement, which could hasten the collection process. Particularly in light of the length of time typically involved in credentialing and review procedures are already in place in many hospitals and physician organizations.
When it comes to switching credentialing providers, there are always concerns (or anything in health care, for that matter).
What is Delegated Credentialing, first of all?
Delegated credentialing is the process by which a health care organization grants another organization the authority to accredit its practitioners. Delegated credentialing goes beyond just verifying credentials because the delegated entity, like a hospital or practice, is in charge of assessing the practitioners’ credentials and then making credentialing decisions on behalf of the delegating healthcare entity, like a PPO.
Implementation of an internal credentialing process.
A health plan must conduct a thorough assessment of the delegate’s capabilities prior to signing an agreement with them for the credentialing so they can see how the tasks are handled. A written review, assigned tasks, a review of the policies, procedures, and files are all part of this. Most insurers demand that a delegate’s processes and procedures for delegated credentialing comply with NCQA Standards and Guidelines. The NCQA Credentialing Accreditation certifies that your practice meets all local, state, and federal requirements, has a designated credentialing committee in place, and has an effective process for verifying practitioner credentials through a primary source.
Agreement on delegation
The roles of each party and their responsibilities, the reporting frequency and performance evaluation procedures, any legal or potential sanctions for non-compliance, and the parties’ rights to final decision-making are all outlined in a delegation agreement, which is a legal document.
The organization in charge of the credentialing will send an updated provider roster on a regular basis to ensure that all data is continuously updated once a delegation agreement is finalized and all other procedures are finished. It also guarantees that, should any changes be made, your health group will be eligible for reimbursement.
Delegated Credentialing’s Advantages
Delegated credentialing offers a number of advantages. From the perspective of a medical group practice, the main advantage of delegated credentialing is cutting weeks off the provider enrollment process. This is because quicker payer reimbursement results from a shorter turnaround for network participation. As your new providers can use their expertise and your patients gain from that care, delegated credentialing can also increase practitioner and patient satisfaction.
