Importance of Medical Credentialing for Healthcare Providers

Medical credentialing ensures only qualified healthcare providers are delivering healthcare services to patients and meeting the standards of quality of care. This protects the safety of patients as medical credentialing assures that only providers with the expertise and skills to perform certain procedures are allowed to practice on patients.

In the medical credentialing process, the insurance carriers verify the providers’ education, license, certifications, malpractice training, etc to validate them to provide clinical care.
Moreover, medical credential plays a critical role in optimizing the practice’s revenue cycle management as payers may delay or refuse to pay for providers who are not credentialed. Besides, it leads to enhanced patient care as patients are more likely to trust doctors for their treatments.

Read the blog to learn more about the importance of medical credentialing for healthcare providers and why it is an integral part of a medical practice’s success.

Prevents Revenue Loss

For a medical facility, it is essential that they get in-network with insurance carriers. Hence, physicians and other healthcare providers are required to be credentialed in order to receive reimbursements for the healthcare services rendered. Failing to do so can lead to payment delay or rejection by the insurers.

Improves Patient Trust

When patients know that their healthcare providers are qualified and have the required licenses to practice, the trust between patients and providers is likely to increase and improve. An enhanced trust between patient and practice results in more positive reviews by your patients and conveys that your healthcare facility is reputed and trusted, which attracts more people looking for treatments.

Assures Patient Safety

As discussed above, medical credentialing helps to maintain patient safety by validating practices and providers are eligible to perform clinical procedures on patients. Also, medical credentialing increases your patient base when your practice has credentialed physicians and medical staff.

Improved Quality in Healthcare

Medical credentialing ensures complete background checks of healthcare professionals, including their qualifications, work history, malpractice, etc, that improve the quality of healthcare for patients in the United States.

Better Payment

Physicians and providers who are credentialed and a part of the insurance network receive better pay from insurance carriers. In short, credentialed physicians and providers benefit a lot in the long run by getting maximum payment. There is no denying that credentialed physicians are considered to be reliable providers by patients and are listed with PPO, HMO, Medicare, and Medicare which enables them to see patients with different plans and receive payments.

For healthcare providers, it is crucial to be credentialed and stay in network with prominent insurance providers to receive maximum reimbursements and improve their practice’s financial performance. Capline Healthcare Management is one the leading service providers of medical credentialing in the United States that takes care of all credentialing needs for new providers and prevents contract termination of providers who require re-credentialing. Our credentialing experts complete your paperwork for proper credentialing application submission, follow up with insurance carriers, and keep you notified with real-time status of the credentialing application.