Why the Best Healthcare Teams Rely on Expert Credentialing Verification?
Credentialing is a process that most patients know little about, but it is nonetheless crucial for their health. During this procedure, a medical organization will verify practitioners’ documents. In other words, they will go through a physician’s degrees, training, malpractice coverage, licenses, training, and other relevant information to determine whether a person is qualified for a position.
The regulatory bodies oversee the entire process to ensure that a verification organization abides by the law. Otherwise, there’s a chance that healthcare providers would allow unprofessional, unlicensed people to offer medical assistance. In that sense, credentialing is the first line of defense for quality medical services.
Due to the procedure’s complexity, medical organizations usually outsource to external CVO credentialing providers. These organizations utilize advanced software and are well-connected with regulatory bodies. As such, they can execute the process much more efficiently than healthcare providers.
What is the reasoning behind medical credentialing?
There are several reasons why we perform credentialing. As mentioned, this is, first and foremost, a quality assurance procedure that ensures all medical practitioners are working according to the US healthcare quality standards. Not only does this make it vital for patients, but it also helps the community by upholding its reputation.
Besides protection, credentialing verification also serves for reimbursements. When a practitioner is verified, it’s much easier to execute reimbursements from third-party payers. That way, a hospital or a clinic can gain access to a much larger number of patients, which would eventually increase their revenues.
Why do healthcare providers outsource credentialing?
Many clinics and hospitals prefer outsourcing credentialing. The process is extremely exhausting and requires a specialized team to execute it. As many hospitals can’t justify the cost of creating a credentialing staff, they perform this procedure as a side task. Because of that, hospital employees tend to be sloppy and disinterested during verification, which often leads to mistakes.
External providers specialize in this task, which is why they usually yield much better results. Not only are they faster, but they are less likely to make mistakes. These external companies are well-acquainted with the current legal frame and use advanced software to streamline the process and eliminate documentation errors.
7 Benefits of Medical Credentialing
There are numerous reasons why companies perform credentialing, and these are 7 most important ones:
1. Quality assurance
Due to the nature of healthcare services, quality assurance is crucial for patient protection. Through credentialing, regulatory bodies ensure that only verified practitioners can offer medical services. Besides checking degree and training, regulatory institutions also need to ensure that a practitioner isn’t under investigation or otherwise penalized.
2. Patient protection
Of course, all of this increases patient protection. If a specific medical task is handled by an expert, the chances of errors drop significantly. As such, the verification process serves as a basis for a quality patient/provider relationship. It serves as an additional safety layer for users who don’t want to risk their life and limb with someone who’s not qualified to perform the medical procedure.
3. More patients
Verified clinics and practitioners can treat patients with medical coverage. Given that this is 92% of the US population, it means that by simply executing credentialing, you have access to a much larger pool of users.
Furthermore, expert credentialing also helps practitioners get to the office much faster. The process usually takes two to three months to execute, during which medical professional gets the usual paychecks. By hiring external credentialing providers and expediting the procedure, patients can get faster access to specialists.
4. Increases revenues
With each new patient that visits your clinic, you can boost your revenues by that much. However, credentialing also prevents loss in revenue due to denied or delayed reimbursements. When everything’s done by the book, insurance payers can easily get money for their treatments.
However, the credentialing process is also crucial for hospitals. When you know that all your medical staff is legitimate, you can avoid blunders that would cost the organization millions in lawsuits.
5. Improves hiring
During credentialing, a verification organization will go through the practitioner’s educational background, residential history, work experience, and other relevant documents. To do so, they either have to contact educational institutions and prior employers directly or utilize advanced software.
Using an analog system of verification is costly and inefficient, which is why most credentialing providers rely on modern software. With the right tools, a specialized company can access large external databases and access files on-demand. This saves a lot of time and money for everyone involved while also ensuring higher patient satisfaction.
6. Improves reputation
Speaking of patient satisfaction, companies that can execute the process faster usually have much better online ratings. As mentioned, quick verification ensures there are many more specialists available in your clinic. It also improves the overall quality of work while giving users peace of mind.
7. Provides competitive advantage
Even if we completely disregard added revenues that come as a result of credentialing, the verification process can provide other tangible advantages for your clinic. It shows potential clients that your organization is serious and committed to quality service. After analyzing specialists’ backgrounds, patients can easily check who’s doing the procedure.
Credentialing is especially great for medical providers who don’t mind spending extra bucks for top talent. If you have elite, verified staff, it usually translates into higher revenues, a better reputation, and a bigger competitive advantage.
Conclusion
We can’t overstate enough the importance of medical credentialing. The process is vital for everyone involved, from governmental institutions to patients and healthcare providers. Through a meticulous verification process, users can rest assured that only the best practitioners provide medical assistance. It can also serve as a promotional method for clinics as long as they hire top-tier talent.
Despite the benefits, credentialing is a rocky road where mistakes are commonplace. Small slip-ups can cause you to onboard a subpar talent or, even worse, someone who’s under investigation. Because of that, you should take special care during verification or hire an external provider to help you out.
