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eClaim Solution > RCM  > Credentialing Process Simplified

Credentialing Process Simplified

Medical Credentialing work is one of the most sensitive works in the world, and it needs utmost care and attention. Doctors and medical staff work day and night to treat and operate on people. It is also one of the world’s most difficult tasks as human life is connected to it. Any major or minor issue can lead to a loss of human life, which is very traumatic.

Because of the medical work, everything related to it is crucial. There is no space for any mistake in the medical field; a tiny mistake can also lead to a major problem. There are many processes and people involved in the medical space; some of them are mentioned below:

The people involved:

  • Nurses
  • Physicians
  • Compounders
  • Therapists
  • Technicians

Processes involved:

These are just a few processes and people involved in the healthcare space; there are more than these mentioned above. The healthcare system is very complicated and cannot be managed by 5 to 6 people. Hospitals have to manage large amounts of people and patients; for that, a vast and experienced team is required, along with a powerful system.

Hiring a new practitioner is hard due to the complex process. Healthcare credentialing is a time-consuming process, and it takes almost 90 to120 days at least for the whole process. It takes several months to complete due to the requirement for detailed background information (keeping in mind that you have not made any mistakes on the application)

A few years ago, every healthcare provider had to be individually credentialed with each insurance plan which took even more time to complete the whole process. Many health insurance companies now use a centralized database to speed up the process. This is the list of the documents which are typically requested. Some health plans may ask for additional details and documents additional.

The details include:

  • Personal information like email address, street address, and phone.
  • Driver’s license.
  • Recent photograph.
  • Medicaid number.
  • Federal Tax ID number.
  • Copy of National Provider Identifier (NPI).
  • Current Curriculum Vitae with complete work history.
  • Medical school diploma and training certificate

Why is Credentialing Needed?

Physician credentialing is very important. Here are the top reasons why physician credentialing services are important:

Improves trust – When a patient gets to know that the medical staff is properly credentialed, it builds trust in the physician.

Lowers risk of medical errors – When you hire experienced medical staff, it will automatically lower the rate of medical errors.

Improved practitioner reputation – Experienced individuals will build your healthcare organization’s reputation.

Benefits Of Physician Credentialing

1. Improves Patient Trust

Trust between medical professionals and patients is really important. Trust enables patients to open up and be comfortable. This will eventually benefit the healthcare organization and medical professional, and the patient, too, as the patient will not go anywhere else because of the trust.

In this way, it will save the patient’s time, and the healthcare organization will generate revenue.

2. Lowers the Risk of Medical Errors

According to research, more than 95 thousand Americans die from medical errors. Credentialing healthcare providers will help reduce the risk of medical errors that may be caused by inexperienced providers.

3. Improves Practitioner’s Business

A patient will always go to their trusted physician. So it is more likely for patients to meet the same physician again and again. Therefore, it improves the practitioner’s business.

4. Improves the Reputation of Health Practitioners

The healthcare practitioners who have undergone the process of credentialing will be trusted by patients. Thus, this will increase the reputation of the healthcare practitioners, and this will also be beneficial for the healthcare organization.

5. Cost Savings

With a robust system, you can also save money by credentialing electronically instead of using papers. Electronic credentialing allows migrating from a paper system to a cloud-based computing solution, thus lowering costs.

There are also other benefits of a cloud-based credentialing system. You can click here to know more about it.

An organized process and third-party credentialing organizations can speed up the long process and help you streamline the whole process.

Healthcare Billing Services can be a long and complicated process due to multiple complicated requirements, but it is worth it for your providers, your practice, and your patients. We can save your time and money by working efficiently.

With our advanced data and technology, we can help you follow best practices. Contact us today and make your credentialing process simple and fast.

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