Medical Credentialing for ENT Practices: No Longer an Option

medical-credentialing-ent-practicesBack in the day, many medical offices and clinics chose not to accept certain insurances or required cash payment for services because patients preferred to work that way. Now, with so much focus on healthcare and insurance in the United States, and with rising costs in insurance premiums, more patients are choosing to use their insurance than ever before. As a result, otolaryngology practices must be prepared to be networked with insurance companies and to work with government payers just to keep up with the competition. Credentialing services, through the healthcare consultant services available at MD Pro Solutions, are essential to the success of medical practices and clinics today.

Fast and Accurate Credentialing
When you make the decision to network with insurance companies, you want to know that you have access to fast and accurate credentialing in order to get on board as fast as possible. This can be key for a practice that is losing revenue due to patients demanding to use their insurance, or for practices that lost a large group of patients who switched to a different practice due to insurance changes. When it comes down to it, a medical practice is a business and you must be prepared to act accordingly through comprehensive record-keeping, best practices for billing and coding, while also keeping an eye on trends to retain patients.

Credentialing services provide practices with the means of becoming affiliated with insurance companies to the medical provider can accept third party reimbursements from the payer. Patients are looking for opportunities to reduce their out-of-pocket expenses, due to the changes in healthcare through the Affordable Care Act (ACA) and also due to the downturn economy. Fast and accurate credentialing through a reputable service is important for the success of any practice, so it is essential that you do everything you can to get on board and start accepting the insurance options that your patients are demanding the most.

More Covered Services
Another reason why accepting popular insurance plans is becoming more important to ENT practices is that these payers are now providing coverage for more services. Pre-existing conditions that were previously not covered, as well as mental health and behavioral conditions, are now under the scope of insurance coverage. Less restrictions are being imposed on the treatments provided to pre-existing conditions, as well as supplemental services and alternative treatments, including massage therapy, acupuncture, physical therapy and holistic services.

However, time is of the essence! Because so many patients are demanding to work with clinics and practices that accept major insurance plans, many of these providers are becoming full and are not accepting new physicians or practices. As a result, the process for credentialing services is now more difficult than it was just a few years ago and it can take a period of months to get approval in some cases. Many insurance companies are closing their provider panels, making it difficult for physicians and other healthcare professionals to join.

It is important to note, that while they may say they are “closed,” some companies are just using this new-found interest in accepting insurance to be more selective in who they will accept. This is why working with a professional healthcare consultant team like the one at MD Pro Solutions can provide you with the experience and tools you need to get fast and accurate credentialing, while taking care of all the comprehensive record-keeping required for approval. Once again, it can sometimes be about who you know to get things done.

Credentialing Services at MD Pro Solutions
MD Pro Solutions offers a wide range of healthcare consultant and support services to otolaryngology practices and clinics. From account management to comprehensive record-keeping, fast and accurate credentialing services to reporting and communications, our team can help your team with all of the auditing, review, training and support services that they need to help grow and maintain your ENT practice. We specialize in otolaryngology to provide you with the very best services that are targeted specifically to your specialty. This is extremely beneficial in coding and billing, as well as having the connections required to expedite our credentialing services and other support options.

If you are interested in learning more about the services that we provide at MD Pro Solutions, or if you would like to schedule a FREE evaluation to determine whether or not our healthcare consultant services would benefit your practice, give us a call at 508-946-1665. MD Pro Solutions was founded by practice administrators and practitioners who specialize in ENT practices, so we are able to develop solutions for medical billing that will truly benefit your business. We are committed to staying on top of the very latest in educational training in order to keep up with all of the changes occurring within the medical insurance and healthcare industry.