Physician credentialing is one of those “necessary evils” that is required to run an otolaryngology practice or clinic. It must be done accurately and it should be done right away to ensure that there aren’t any unnecessary delays. Some of the issues associated with delays in credentialing services include problems with scheduling and delays in cash flow, so it should be done before the new physician even starts on at the practice. It requires comprehensive record-keeping and a lot of time and patience, but it needs to be done.
Credentialing is an important ingredient is ensuring that your medical billing system is working properly. Fortunately, if you are unable to take care of it, there are healthcare consulting services that can help by providing you with fast and accurate credentialing services. So the question is, is it better to do it yourself or hire a professional? If you decide to do it yourself, there are some tips below that may help you to expedite the process. However, if you decide to hire a pro, go ahead and contact MD Pro Solutions by calling 508-946-1665.
Tip #1 – Start as Soon as You Can
Credentialing can take anywhere between 90 and 150 days or more, depending on how busy the payer’s network happens to be at the time. You are not going on any regulated time, but on the amount of time that the payer is committing to working on the applications, so it is important to give yourself as much time as possible. As soon as you get confirmation that a new physician is coming on, you should get started on the credentialing to get a head start.
Tip #2 – Details Matter
A large majority of credentialing services applications within the medical billing system are missing essential data that is needed in order to process them. This is why many applications are delayed or denied. The most common areas where the missing data comes from includes malpractice insurance, hospital privileges, attestations, and the work history and current work status of the physician, including the effective date of work at your practice. Comprehensive record-keeping is key to being able to fill out credentialing applications quickly and thoroughly, without leaving anything important out of the documents.
Tip #3 – Know the Law
Stay up on the regulations for your state regarding timely credentialing services, which can include reciprocal regulations if the new physician is credentialed in another state by the same payer. This can sometimes help to streamline the process, but not always. Some states also allow for in-state credentialing services, which means that they would not have to go through the complete credentialing process if they moved to your practice from within the same state. Check with a healthcare consulting firm or local agency to find out which laws apply in your area.
Tip #4 – Link the Start Date
In some cases, it is easier to take care of credentialing services by linking the start date of the physician at your practice or clinic to their submission of the credentialing paperwork. This method gives the physician a little push to move forward with the paperwork and helps the physician in the long run, by helping him or her to get on the schedule faster. The start date can be effective 120 days or more from the date that the paperwork was submitted.
The Best Solution
However, by far the best solution is to hire a healthcare consulting firm to take care of the credentialing services for you. MD Pro Solutions has built a solid reputation within the ENT medical billing system industry for providing fast and accurate credentialing services. We advocate comprehensive record-keeping and can assist, train and provide support for your entire medical office staff to help you improve the results at your practice or clinic.
Credentialing can be a very tedious, time consuming job, especially if you have to keep going back and forth to get all of the required information. If you insist on doing the work yourself, make sure to take care of some housekeeping and go over comprehensive record-keeping and gathering techniques with your staff and the new physicians to ensure that you have everything you need to get the job done. If you get stuck and need help, contact our team of healthcare consulting professionals to help you get the job done right.
Give us a call at 508-946-1665 to get a FREE estimate on any of our professional medical billing system services, education and support. Our team of highly trained and experienced agents can help you with a wide variety of needs to help your medical practice get on the road to success.