Top Mistakes in Medical Provider Credentialing Process

Medical provider credentialing is a hectic, time-consuming, and complex process that if not done aptly can cost practice time & money.

Verifying a medical provider’s credentials doesn’t sound challenging, but there are a lot of problems that may occur slowing down the reimbursements and exposing the practice to liability. 

A practice’s entire revenue cycle requires a foundation of proper medical credentialing. At the point when mistakes are made, revenue is lost or delayed, legal liability increases, and you can run into a wide range of coverage and referral issues. 

Practices that make these common mistakes with their medical provider credentialing waste valuable time and money. 

Mistakes in the medical provider credentialing process

Here’s what you can do to avoid the mistakes in your medical provider credentialing process.

• Timing is crucial

While welcoming a new provider, there isn't a moment to spare. It is vital to take the appropriate amount of time necessary for credentialing rather than waiting a month before a new provider arrives.

You must:

1. Allow for time to process applications and get approvals with each payor
2. Take time to review each nitty-gritty detail for accuracy 
3. Make sure you follow up during the process of credentialing 
4. Be timely in re-attesting CAQH profiles

• Attention to detail

Incomplete information and errors in application lead to postpones in processing applications and possible denials.

Applications are commonly denied due to inaccuracy errors like:

1. Omitting or making mistakes in data
2. Incomplete lockbox address
3. Incorrect NPI numbers
4. Misspelled Names

Insurance credentialing services are directly tied to your profitability. When there are mistakes in the documentation it could hold up applications or experience a denial. This leads to the timely application process having to start over.

• Persistence pays off in credentialing

Lack of follow-up throughout the application process can cost your practice tens of thousands of dollars simply by overlooking one letter or notice.

Thus, it is critical to follow up at regular intervals, keep notes and follow up to confirm each application was received.

Let Capline handle your credentialing needs

The day-to-day operations of running a practice come with a lot of challenges. Medical credentialing is a very complicated process that can be challenging to manage. 

Now bid goodbye to your credentialing hassle and focus on delivering quality patient care. We at Capline Healthcare Management, offer expertise in handling your credentialing work flawlessly.

We make medical provider credentialing services easy for you.

Our team can help you in-

1. Keeping away from heaps of administrative work and finishing up filling out the forms.
2. Getting credentialed by healthcare plans significantly quicker.
3. Receiving real-time status of credentialing transactions.