Physician Credentialing Services Can Save You a Lot of Time

by | Dec 22, 2021 | Medical Billing

The internet today is a major part of the healthcare system. A majority of patient appointments nowadays have found a place online. This also has extended to updates regarding treatment and other health-related activities. 

Before any physician can have an online profile as part of their practice, the hosting portal or platform needs to verify the genuineness of the physician. In addition, they should garner basic information like their registration number, board certifications, admission privileges, work history, etc. 

You also perform background checks to rule out any prior medical malpractice or otherwise untoward event in the doctor’s earlier period of caregiving. You can call this process of authenticating a physician’s record and ascertaining whether the practice falls under illegal or illegitimate as credentialing.

Process of Physician Credentialing Services

Physician Credentialing Services Can Save You a Lot of Time

Under this process of physician credentialing services, the entire professional life of a doctor is vouched for and ascertained to be true. For instance, it includes their degrees and board certifications, years of practice, hospitals where they help and provide care. Further, it also looks after their clinic and registration numbers, and anything else related to their work histories.

Most health maintenance organizations and online healthcare portals have a physician credentialing service in place. This process begins with the physician (or healthcare platform/portal) completing an application for charges against care provided. Later, they submit it to the insurance carriers. 

Once the carriers accept such an application, the process of credentialing is complete. Besides this, healthcare provider enrollment, or the procedure of including a doctor as a caregiver with a particular healthcare portal, also falls under physician credentialing service. 

Undertaking a physician credentialing service ensures that the doctor’s information and records are up-to-date in the insurance carrier’s accounts. Also, the insurance carriers receive intimations about the changes in hospital affiliations and practice locations as part of credentialing follow-up.

This process of physician credentialing service is really beneficial to both doctors and health maintenance organizations. Let us look at how and why.

Less Time Wasted in Undertaking Self-Credentialing by the Physician:

According to a study, physicians spend a significant amount of time in activities not related to direct caregiving and examining patients. Paperwork and other administrative tasks like scheduling eat up this time. 

When a doctor undertakes the process of credentialing themself, they lose valuable time. This time, they could otherwise spend productively examining patients and generating revenue. In such a scenario, outsourcing the physician credentialing service makes a lot of financial sense.

Professional Handling of Claims and Payments by Experts:

Physician Credentialing Services Can Save You a Lot of Time

As a medical professional, suppose you have hired a third-party entity to undertake your credentialing. In that case, you can rest assured that all the paperwork related to claims processing and ensuring that payments are secured will be undertaken by them knowledgeably and professionally, devoid of errors. 

Getting claims approved by insurance carriers can be tedious and a little complicated. Leaving this job in the hands of experts and experienced to do so will turn out as a strategic move. Moreover, it will prove quite beneficial to your practice.

Physician credentialing services ensure that the entire process of submission of forms and claims and any follow-up required in this regard is carried out meticulously by personnel trained for the same.

Updating Changes to Your Professional Profile:

Your physician credentialing service does not merely undertake a background check on you and verify your details. It also follows through and keeps track of any changes in areas of your functioning. For instance, it updates for any change in location practice, hospital affiliations, etc. 

Imagine informing every known as well as a prospective patient that you are now practicing in a different area. You may have a lot of work to do. Thus, the credentialing service follows such details, and updates your information regularly. So once you have a credentialing service on board, you can forget any headache about intimating new information to those concerned. It will all be taken care of.

Physician Credentialing Services Also Provide Additional Services

Nowadays, you have physician credentialing services that are also into revenue cycle management, maintenance of finance and accounting services, and marketing. They basically offer you a bouquet of services in the realm of administration which takes away a massive chunk of the paperwork that otherwise you would have ended up doing. 

Overall and in the long run, this system simplifies the entire caregiving process for you, so you have all the technicalities of administrative work sorted out under one roof. What’s not to like?

Come, partner with us today, and get more productive in your medical career!

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