Medical credentialing can be a tedious process for any medical practice, but it’s a process that must be done correctly. Without proper credentialing, there can be serious consequences, like delays in getting claims reimbursed, fines/penalties, and even harm to the patients themselves. There are many mistakes that can occur in the medical credentialing process, and we’re here to tell you how to avoid making these mistakes yourself.
Don’t Depend on Limited Administration and Staff
Medical credentialing can be a long and time-consuming process. It requires great attention to detail, patience, and strong precision. An organization has to verify the licenses and certifications of each provider that provides patients with services.
Some healthcare systems might not provide enough resources or staff members in order to get the credentialing process completed properly. This can cause a whole lot of problems, like lost revenue because of credentialing delays, and also overworked staff members who are more likely to make credentialing errors.
Make Sure Your Enrollment Applications are Complete
Typically, you’ll need a lot of information in order to complete an enrollment application. Nevertheless, it’s important to gather all of the needed data. Otherwise, if you have insufficient data, or if the data you provide isn’t accurate, it can cause reimbursement delays because of the claim denials your practice will receive.
Don’t Let Physicians Treat Patients Until Medical Credentialing is Done
Hospitals must verify all of their physicians’ credentials before allowing them to treat patients. After all, you wouldn’t want your patients to be treated by physicians who aren’t properly certified. It can put the wellbeing of those patients at great risk, and your practice will be held liable for any and all damages that occur as a result of letting an unlicensed physician work with a patient. While it can be a long process to get your physicians verified, it’s a necessary step to ensuring the safety of your patients and your practice.
Avoid Concealing Prior Adverse Action
No provider should ever ignore an adverse action, as this can be a severe oversight. Along with addressing current adverse actions, you also need to perform background checks on your physicians to see if there are previous actions that need to be addressed. When collecting information, make sure that it’s collected from a trustworthy source that gathers information from primary sources.
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