What Are the Benefits of Hiring a Credentialing Company?

Proper credentialing is beneficial, as it helps providers and medical institutions comply with healthcare standards and receive payments. The credentialing process is often time-consuming and complex, taking your attention away from patient care. Credentialing companies can allow you to focus on your core competencies by handling credentialing on your behalf. Here are some of the benefits of hiring a professional:

Revenue Generation 

A credentialing company can facilitate easier enrollment with insurance networks. Insurance companies typically require providers to be credentialed before enrolling them in their networks, as it shows they are qualified to deliver high-quality care. Proper credentialing can translate to faster enrollments, allowing providers to submit claims for services rendered and receive timely reimbursement.

A credentialing company can improve a healthcare organization’s revenue generation by expediting credentialing and hiring processes. Credentialing companies understand what insurance payers require, so they can save time and get you enrolled to receive payments for your services. They may also have well-established relationships with external parties like educational institutions and licensing boards, allowing them to get the information needed to determine a provider’s competence quicker than you would alone.

Patient Safety

Determining whether a provider can provide safe and quality care can be challenging if you don’t know what to assess. A credentialing company can help you evaluate a provider’s competence by verifying their qualifications and assessing their work histories. They can identify inconsistencies in application forms or potential red flags in work histories that could jeopardize patient safety. They can also reveal forged education certificates and criminal records, if any.

A credentialing company’s findings often influence their recommendations during the hiring process. You can help safeguard patient well-being and protect your facility’s reputation by acting on a reliable credentialing company’s recommendations on whether to work with providers who apply for jobs in your organization.

Risk Management  

Incorrect credentialing can pose a significant financial risk for providers. It can delay their insurance enrollment, affecting their ability to receive reimbursement for services rendered. A credentialing company can help you mitigate this risk. They can verify providers’ credentials to make sure they’re up to date with payer requirements and help with enrollment applications to prevent errors.

Industry Expertise 

Hiring a credentialing company gives you access to their industry knowledge. These companies stay current with credentialing regulations and understand the intricacies of the credentialing process. They have dedicated staff with in-depth knowledge of the credentialing requirements in different healthcare specialties, saving you time on research. By leveraging their expertise, you can contribute to a decreased risk of error during the credentialing process, allowing you to focus on delivering quality healthcare services.

Time and Resource Efficiency 

Credentialing is a time-consuming task. It involves collecting providers’ details regarding their qualifications, coordinating with parties like education institutions and certification boards to confirm the qualifications’ legitimacy, and conducting extensive background checks. Managing this process in-house may prove burdensome for your team and divert valuable resources and time away from your core task of patient care. 

Hiring a credentialing company can help save time and resources. These companies have robust systems in place to manage every step of the credentialing process efficiently. You only need to provide pertinent provider information and leave everything else to them. 

How To Support Your Chosen Credentialing Company

Credentialing is a collaborative process that requires input from your chosen credentialing company, healthcare providers, and your healthcare facility. You can streamline credentialing by communicating your needs and expectations from the beginning. Give your credentialing company information on your organization, its specialties, and the types of providers you employ to help them tailor their services to your requirements. Communicate your timelines from the onset of services to avoid delays in provider enrollment and hiring.

You can also support your credentialing company by sharing documentation and information promptly. Understand what the company you hire needs before releasing your application forms so you can capture all the necessary details. Credentialing companies may need information on providers’ education, licensing, certifications, malpractice history, and work history. Be ready to respond to requests for additional information throughout the credentialing process. Prompt responses help the process move smoothly.

Utilizing Credentialing Companies To Streamline Your Processes

Credentialing companies can help providers enroll in insurance networks faster by expediting the credentialing process and helping them complete insurance enrollment applications efficiently. They can also help healthcare organizations make better hiring decisions by verifying providers’ qualifications. Hire a reliable credentialing company with a proven track record for optimal results.