4 Reasons to Outsource Credentialing by a Medical Billing Company

Medical billing companies save revenue cycle management for clinicians. Without the assistance of medical billing services, we doubt the efficient running of medical practice.

The Healthcare industry is quite sensitive and responsible. Physicians are supposed to practice their skills for the ideal health status of individuals. Especially in the ongoing approach of the value-based healthcare system, physicians need to modernize their treatment methods now more than ever. Hereby, medical billing companies create medical bills and handle the billing tasks to get the reimbursements. Consequently, physicians can pay attention to their actual work.

However, in addition to the billing process, a professional medical billing company also offers credentialing services for clinicians, which is a vital part of revenue generation.

What is Credentialing?

It is a process, in which hospitals, insurance companies, or healthcare authorities verify and legitimize the educational background, expertise, and qualification of a clinician. Generally, this process takes place before including a physician in the working network.

Why is Credentialing Important?

When physicians are credentialed, they get timely and rightful reimbursements from the insurance companies.

Medical credentialing is not an easy process and requires extensive focus from the start of the process to the end.

No Immature can look into clinicians’ past and derive professional outcomes. The credentialing process is legal and can result in penalties if done unethically. Hence, this responsibility should only be given to medical billing companies.

What are the Challenges that Occur During This Process?

Credentialing Takes Time

Checking one’s background is a complex process. Therefore, it requires at least 60-90 days to fully credential a clinician.

Medical billing services when enlisting a physician for credentialing, are required to complete the whole process before he takes up a new patient. There is no room for error as the process involves the verification of sensitive fields such as employment history, education, medical training, licenses, and more.

Peers Don’t Cooperate

It is obvious that physicians are always tight on their schedules. Hence, there is little possibility that peers, who can give a vote of confidence for the physician will be able to respond to inquiries on time.

To avoid this delay in the credentialing process, physicians can inform their peers prior to the process. Moreover, they can also set a time to complete this task.

No Access to the Latest Information

Physicians need to have access to up-to-date information. However, medical practitioners are so busy in their lives that they remain oblivious to the latest information. For Example,

Clinicians working in ambulatory surgical centers (ASCs) have to reevaluate their credentials after 1-3 years. When different clinicians have a different schedule for credentialing, it becomes hard for ASCs to manage all.

Thus, no access to the information at the right time creates issues for the credentialing service providers and the confirming authorities.

Inability to be Compliant with Value-Based Healthcare

Different states have different healthcare plans and so physicians are supposed to stay true to all the state exchange and federal healthcare plans.

Another challenge that a credentialing medical billing company faces is that physicians have to treat a reasonable number of patients to handle revenue cycle management. Moreover, medical practices should implement the right healthcare strategies. Otherwise, they’ll not be able to get reimbursements for the rendered services.

Considering the difficulty, medical practitioners choose to outsource credentialing services. There is no way that unprofessional individuals should not take responsibility for this task. After all, physicians’ revenue generation is based upon it. Thus, only, a medical billing company as P3 Healthcare Solutions can outrun all the above-mentioned challenges for credentialing and insurance enrollment and offer an efficient solution.