Top 5 Reasons To Outsource Credentialing

Top 5 Reasons To Outsource Credentialing

Top 5 Reasons To Outsource Credentialing 

Credentialing is a long process of obtaining details of training, certifications, and licenses. Verifying all the details and finally assessing the practitioner to provide care and service to the patients, in conjunction with patient safety and continuous improvement. It is a mandatory process for reimbursement from Medicaid, Medicare, and private insurance. 

The pressure to speed up the revenue cycle with shrinking budgets and credentialing demands put pressure on the dental team. Here are the top 5 reasons to outsource the credentialing process.

Elevate ROI 

Credentialing partners can considerably reduce costs in terms of manual or additional labor, paperwork, and less workspace, which saves up to 20%-80% in costs. Additionally, you can utilize the resources for business growth and a greater return on investment. 

Here are two instances of how outsourcing can help reduce the operating cost: 

  • Less workspace directly related to operating cost per person- If you outsource the credentialing process, the remote assistant will have their workstations, and the dental office doesn't need as much space for the practice. If you have an empty workspace, it can get utilized for other tasks besides credentialing to keep the dental practice running smoothly.   
  • Less labor cost reflected in the company's revenue- It is expensive to hire labor in  America. A college graduate typically earns $66,000 annually, and an advanced degree holder earns $77,000. Outsourcing can save $10,000 per year per person. 

Ensure Compliance with the Law 

Hospitals, clinics, agencies, and small healthcare facilities work with several providers. Each institution has different requirements, and it's an amount of work to keep track of everything in-house and ensure that everything complies with every new provider. 

Missing single information or verification can impact both the candidate and the business. The consequence can result in the candidate losing their license, and practices can get themselves into lawsuits for malpractice claims. 

Re-attestation of credentials is mandatory every 90 days, and partnering with the credentialing organization can help the practitioner navigate the payor's fluctuating process correctly so that the dental practice starts receiving timely payments. 

Improve TAT (turnaround times) 

What is so great about outsourcing is that traditionally it takes 60-120 days for healthcare insurance carriers to verify credentials. Even more time and extra labor if you work with multiple providers.  Part of the staff is busy with credentialing compliances instead of other necessary tasks.  Unnecessary delays can stop the cash flow. 

However, the turnaround times for an outsourced credentialing partner is between 10-15 days. The improved turnaround times allow the practitioners to work without any worries. 

Shrink Human Errors 

The credentialing process requires constant fact-checking on certifications, degrees, and documents,  and it becomes even more challenging when the organization's in-house credentialing process gets performed manually. It is easy to make mistakes in this long and demanding cycle.

One misplaced document and one misspelling can accidentally turn the prospective candidate into an unqualified candidate. Outsourcing can reduce human errors that are common with manual credentialing. The team of experts with automated software can reduce complaints, costs, and complications. 

To simplify the process, always hire an outsourcing partner with automated software to conduct real-time backgrounds, education checks, verification, and follow-ups. 

Boost Productivity 

When things become chaotic, we all feel that we do not have enough hours in a day to get all the work done. There are so many different tasks, and above that, a credentialing process work, like paperwork, spreadsheets, documentation, and unexpected developments in every turn, requires so much attention that falling through the cracks can have a devastating impact. That means time is spent just making sense of the files. 

An outsourced credentialing partner can take care of all the documentation work, saving a lot of time and labor for starters. They can verify, update, and check errors while you can concentrate more on patient care and the practice. By outsourcing, you can be more confident about the process and thereby see improvements in productivity and efficiency.

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