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Provider enrollment and Credentialing is your Key to Success

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Provider enrollment and Credentialing is your Key to Success

Provider enrollment and credentialing is the backbone of every healthcare practice. As a provider, it is essential to be enrolled with commercial and government insurance companies or payors for maintaining a steady flow of referrals and accounts receivables.

Credentialing is the complex process by which a provider’s background, education, identity, residency, licensing and other criteria are verified. Provider enrollment is the process of requesting enrollment with commercial payors, Medicare and/or Medicaid.

Are you establishing a new practice? Are you affiliating with or joining a new group of practitioners? Do you want to enroll with new payors? Is a new physician joining your practice?

Well, these are instances why you may need regular provider enrollment and credentialing services. It can prove beneficial to outsource such services to a medical billing company to ensure they are done in time and updated.

Salient Features of the Process

Key Benefits of Efficient Enrollment & Credentialing for a Medical/Dental Practice

  1. Faster credentialing will assist faster enrollment with payors resulting in steep reduction of AR delays.
  2. Reduction in claim denials will give way to smooth cash flow and a financially healthy practice that is able to grow and profit.
  3. Provider will gain more patient referrals from the network.
  4. Improves turnaround time to within 60 days of submission of claims.
  5. Compliance with insurance payors avoids legal hassles and yields a more efficient revenue management cycle.
  6. Avoids wasting of staff time in follow ups for delayed AR.
  7. Accelerates revenue as the patients having insurance of payors you are enrolled with can be seen without delay.
  8. Improves provider’s credibility among payors, which promotes prompt and accurate payments.
  9. Increases customer satisfaction and goodwill due to a hassle-free process. The practice earns great reviews both online and through word-of-mouth.

3 Mistakes to Avoid

  1. Inaccuracy in filing out the information
    When the process is already lengthy, every error can increase the timeline and delay much needed enrollment. Even simple mistakes in information such as practice address or failure to sign the forms can cause significant delays and major mistakes can be grounds for denial.
  2. Delay in starting the process
    It is advisable to start the credentialing and enrollment process at least 90 days prior to opening of a new practice. Even if you are joining an existing practice, it is required that the process is initiated well in advance. You may choose to outsource to a medical and dental billing company for ensuring accuracy and regular follow ups.
  3. Lack of follow-up with payors
    Credentialing process is not only lengthy but can take months to process for many practices. Ensure regular contact with the payors and stay up to date on application status to shorten the wait time.

Astron EHS – Provider Enrollment & Credentialing Services Company

As professionals who manage medical and dental revenue cycle management every day, we understand how time consuming, complex and annoying the processes for provider enrollment and credentialing are. Specially if you are working as a team of physicians, it is required to submit and monitor multiple applications and handle the overwhelming paperwork on time with accuracy.

At Astron EHS, we are well equipped and experienced to handle all these tasks for you, so you can focus on the most important part of your practice – treatment delivery.

Get in touch with us!