Avoid 10 Credentialing Pitfalls by Using the Right Software

February 27, 2017
Make Your Credentialing Technology Work For You

Medical credentialing and provider enrollment are critical components of the revenue cycle, yet these processes pose major challenges for small practices. Since healthcare technology lags considerably behind that of other industries, many tasks are still done manually or with spreadsheets, leading to fragmented processes and human error. By using the right credentialing and enrollment software, you can streamline workflows to maximize revenue and productivity.

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Here are 10 credentialing pitfalls you can avoid by using the right software:

  1. Instead of keeping track of tasks manually, you can utilize technology that automates workflows. Check off items on your “virtual to-do list” with just a few clicks and use metrics to evaluate process performance.
  2. Electronic tools minimize credentialing “busy work” with the ability to auto-populate forms, reducing data entry requirements. Software systems save demographic information and other data and automatically enter it to complete required documents. This feature saves time and reduces errors, as employees no longer have to engage in time-consuming, repetitive data inputs. You can also run queries and renew forms without the tedium of reviewing paper documents. On the enrollment side, this is especially helpful as different providers have their own sets of forms and data requirements. Electronic signatures save time, as staff do not have to wait for forms to be signed manually.
  3. In-house server-based systems limit how many users can access them at one time, which can be problematic when allocating tasks among employees. The latest software expands data availability, reducing task-coordination hassles.
  4. With intuitive interfaces and easy-to-use features, the latest credentialing software eliminates the need to complete a long sequence of steps or navigate complicated menus to locate provider information.
  5. The right software solutions are low-maintenance. With cloud-based options, you do not have to manually install the software. You can access it via a browser, and updating can be done quickly and relatively easily. Additionally, since the software is so user-friendly and comes with responsive customer support, you don’t need to set aside large chunks of time to learn how to operate it or train staff to use it. The software essentially walks you through various tasks.
  6. With the right technology, you no longer have to painstakingly search through stacks of paperwork and keep large volumes of forms in a filing system. Instead, digital document management stores important documents- correspondence, credential verification information, and other materials- and keeps them organized in a logical order.
  7. You no longer have to contact payers or consult spreadsheets to look for credentialing expiration dates. Superior software sends automated alerts and reminders when providers’ certifications and licenses are up for renewal so staff can keep the credentialing process as smooth as possible. The same applies for provider enrollment. Up-to-date software allows you to maintain records of the health plans providers participate in and monitor their enrollment status.
  8. You won’t have to send correspondence through the mail. With automated peer referencing, you can obtain required information much faster than traditional methods, as you can send and receive documents virtually. This also means your practice can avoid postage costs and mail-delivery delays.
  9. With current credentialing software, you’re not required to play phone tag or spend hours tied to your desk as you attempt to follow up on providers’ credentialing statuses. Web-based solutions allow you to track processes in real-time.
  10. Since the latest credentialing software significantly reduces errors, you will spend considerably less time appealing denials. Credentialing technology flags most mistakes before documents are submitted. When denials do occur, you can locate the source quickly to avoid disruptions in provider privileging and reimbursement.

The latest credentialing software minimizes paper trails, facilitates optimal process management, and drastically reduces credentialing time. Give your practice the tools they need to avoid these credentialing pitfalls by supplying the optimal software.

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