Tips for Provider Credentialing Process

Tips for Provider Credentialing Process

Provider credentialing is an important process for verifying the expertise, willingness, and interest in providing dental care. Failing to understand and follow the provider credentialing process results in denial of provider payment. Provider credentialing requires you to fill up a form. It is a continuous process that involves a lot of hassle. Therefore, to make your practice efficient, it is important to outsource credential service provider. They will help your practice operate without any hindrances. The provider credentialing process involves submitting documents and forms.

Factors to be taken into account for successful credentialing

Staying aligned with CAQH
Council For Affordable Quality Healthcare (CAQH) has been operating its program for the last few years. This program is aimed at authenticating the accuracy of credentialing information that is submitted by healthcare companies to health plans.

Create an efficient credentialing process
Provider credentialing is not something that just happens accidentally. It requires careful planning beforehand. It could take several weeks to process the credentialing paperwork. The problems that come across in the initial phases can be skipped by getting an early start on the process. Get assistance from a credentialing service provider is one the best ways to get ahead of everything.

Focus on clean and accurate applications
Once the applications are returned, make sure to review and assess each of them for accuracy before sending it to the payer. An application that is devoid of errors and easy to understand definitely gets processed faster.

Providing the present copies of paper documents
Your credentialing specialist needs to put forward the current copies of licenses and other documents. If any of these documents include incorrect data or is expired, the credentialing process will delay. This will hold up the credentialing process as it requires time to receive and submit updated versions of these documents. Reprocessing the new document again may take some time.

Creating an effective credentialing process may take some time but it definitely helps over the long term. So, practices must take a step forward in maintaining a workflow that has all the required documents and forms. Understanding how credentialing works has a positive impact on how smoothly a practice runs. To ensure that credentialing always remains up to date, you must have a process and plan in place.

We hope these tips help you in moving ahead with a streamlined credentialing.

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