Physicians Credentialing privileges and status is directly linked to revenue flow of the practice. Delayed or expired credentials can affect the Medical Billing and Reimbursement process. Planning on the Physician Credentialing or Re-credentialing requirement in advance saves revenue loss to greater extend, however handling Physician Credentialing can be a cumbersome and laborious task involving lot of paper-works and supportive documents; making it vulnerable to errors and mistakes in processing the application. Discussed below are few point to understand how Credentialing Mistakes lead to Revenue Loss:
Planning and Time Management
Physician credentialing is a long and detailed process of validating Medical Practitioners complete documentation from education to work history and licensures, therefore the credentialing cycle can be anywhere from 45 to 180 days. While the process can take almost three to six months, it is crucial that the physician and practitioners plan a head to initiate the credentialing process well in advance and process them within the time limit to avoid revenue loss. Read below to understand when to initiate or look out for Physician Credentialing Services:
- Physicians just out of their medical graduation looking to join any Medical Group, Hospitals or Medical Practice
- Physicians moving from one employer to another
- Physicians starting their own Medical Practice
- Practices or Medical Group hiring new physicians
Accuracy and Completeness
The process of Physician Credentialing involves verification of a gamut of documentations, certifications and licensures to assess the physician’s educational qualification, medical graduation, internship, residency, career history and malpractice details. Processing the credentialing application is a tedious task which requires utmost care to ensure accuracy and completeness of the information given; as even an involuntary miss or typo in the details submitted can lead to unwanted delays and rework of the entire Credentialing Process. Inaccurate or Incomplete application or documentation will affect the timeline and revenue flow for the physician or Medical Practice.
CAQH (Council for Affordable Quality Healthcare, Inc.) Maintenance
Almost all insurance companies access CAQH for provider’s latest profile, keeping CAQH current by regularly updating the same is basic requirement to avoid lapse during credentialing process.
Know How Credentialing Mistakes Leads to Revenue Loss:
Any errors of incorrect information as listed below in credentialing application can lead to unwanted delays in getting the privileges to see patients or processing the claims with the specific Insurance:
- Not planning well in advance
- Incorrect data or information in Credentialing Application
- Insufficient or outdated supportive documents
- Missing required attestations and signatures
- CAQH not updated
All these miss will end up in multiple to and fro emails and follow-up affecting the timeline for Physician Enrollment thereby causing a delay in Medical Billing and revenue loss.
Avoid Revenue Loss Due to Physician Credentialing
Quality and timely Credentialing services is fundamental for any physicians to ensure their reimbursements are collected without delay or denial. Experienced credentialing services reducing the hassle for physician and carrying out the entire process smoothly with regular follow-ups until privileges are assigned is the prime requirement for any practice.
About MGSI
MGSI is a full service Medical Billing and Revenue Cycle Management Company located in Tampa, FL. With over 25 years of expertize in Healthcare Industry MGSI guarantees to reduce revenue loss due to delays in Physician Credentialing. MGSI has experience handling CAQH and PECOS Credentialing for all Government and Commercial Insurance carriers. To know more about MGSI and our services call 1-877-896-6474 or visit www.mgsionline.com