Credentialing verifies that if the healthcare provider follows industry rules and regulations or not. It is a process of registering with the insurance company and making a commitment that medical providers will accept the payment from the insurance provider in exchange for their service. Hospitals, physicians, and doctors will work closely with credential verification specialists. They will also contact insurance companies and other credentialed verification organizations.
On the other side, many organizations consider these services just a waste of time. Comparing and contrasting the pros and cons, we can say that it helps to build credibility in the healthcare industry.
Medical credentialing gets is a process to understand whether or not the provider is qualified to render the services. Providing the best care to the patient has been the top priority of medical credentialing. The process is complex and requires verifying all doctors for the requirements of proper credentialing, which is needed to do with a checklist to repeat the same process iteratively.
For example, a physician’s credentialing is checked repeatedly against significant publications like registries, death master files OFAC, the National Abuse registry, and many other such resources.
Positive reviews play a pivotal role when the patient decides to book an appointment. Organizations need help determining whether particular healthcare professionals are working to provide a specific service. Resultantly, it builds trust.
Getting the best candidates in your organization to serve the people is tricky. In this regard, medical credentials help hire the best candidates for your firm. It is an ideal way to align the staff who have just completed their initial practice. Also, credentialed doctors and nurses positively impact the other staff members, new doctors, LVN, PAs, RNs, and support staff.
Since 2007, there have been 100,000 deaths due to medical errors in the US alone. Some of them were due to human error, but with proper credentialing of the physicians, you can reduce medical errors. Common errors include
Internet and social media plays a vital role in checking the authenticity of any medical professional before making an appointment, just as medical credentialing. However, this approach also has raised doctors’ interest in paying attention to online marketing. According to a recent case study, nearly 72% of patients look for a five-star rating when selecting a physician or treatment facility. This is why online reputation matters a lot for physicians. Another way, 80% of the patients trust online reviews compared to personal recommendations.
Healthcare organizations and physicians operating private practices earn revenue by outsourcing financial management tasks to medical billing companies. To help medical billing practices, physicians need to be credentialed for their services. Thus, physicians need to be credentialed to maximize the reimbursement and get paid from the insurance companies like Medicaid and Medicare.
Also, credentialing saves you from loss and protects your revenue from lawsuits. If you get involved in litigation, you will need complete credentialing details of the working practitioners. For instance, if there are malpractice claims against any of your physicians, you can bar yourself for legal responsibility by showing authorities that you have fully verified the doctor’s credentials and have been renewing them with time. Doing this will also safeguard you from heavy fines due to legal disputes.
Whether it’s profession-driven or market-driven support, the medical industry leverages support services and their benefits. Both service providers and patients benefit from credentialing. At Physicians Revenue Group, we can assist you in implementing the best strategies for your practice.
Your business will receive the right feedback and solutions to improve your billing process from our expert consultants after they review your reports, trends, industry changes, and policy updates.
Get in touch with us today for more information about our tailored medical credentialing services or other medical billing solutions specifically designed for medical practices and healthcare providers.