Why Credentialing is Important for Healthcare Professionals? - PowerPoint PPT Presentation

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Why Credentialing is Important for Healthcare Professionals?


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Title: Why Credentialing is Important for Healthcare Professionals?

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Why Credentialing is Important for Healthcare
Medical provider credentialing is a process
through which healthcare facilities and insurance
companies access and confirm the qualification of
a provider. The process is vital as it helps
maintain high standards in healthcare. Since
credentialing tells us whether a provider has the
necessary training or expertise to practice
healing arts, it is paramount for everyone
concerned to understand why credentialing is
necessary. In this article, we will try to answer
why credentialing is Important for healthcare
professionals? Lays Foundation of Excellent
Patient Care Provider credentialing installs
confidence in patients. Knowing that the provider
has been thoroughly inspected by the experts
creates that bond of trust between provider and
patient, laying the foundation for excellent
patient care. Patients who trust their providers
naturally follow their advice, from dietary plans
to testing a new drug or having surgery. Without
trust, patients are less likely to be open and
honest with the providers about their medical
histories current concerns signs and symptoms
of a disease and so on. Patients who have
confidence in their providers are more likely to
stay with the practice and not seek a second
opinion. Provider credentialing is beneficial in
retaining skilled employees also. A healthcare
organization with fully credentialed nurses and
healthcare providers is more appealing to new
physicians, PAs, LVNs, RNs, nurse practitioners,
and support staff.
Why Credentialing is Important for Healthcare
Source freepik.com
Why Credentialing is Important for Healthcare
Ensures Accurate Reimbursements Every healthcare
service provider needs to get credentialed to
receive accurate insurance reimbursements. Big
healthcare organizations up to small healthcare
practices, of them, earn money through partnering
with health insurance companies. After
successfully credentialed with insurance
companies, providers need to enter into an
agreement referred to as a payer contract. Among
other clauses in the payer contract, there are
reimbursement clauses that determine how
facilities and practitioners will be reimbursed
by the insurance companies for the services they
provide. Getting the documents completed on time
ensures that the new nurse or provider youve
employed can start offering services on the first
day. Provider credentialing is not something to
push off. The credentialing time frame differs by
state due to changes in legislation and
credentialing laws. Before allowing your staff to
interact with patients, private health insurance
companies, Medicare and Medicaid will want
confirmation from insurance credentialing
services. If your medical practice cuts corners
in the credentialing process, you could open up
yourself and your practitioners to financial
losses. Enhances Your Practice Reputation
Why Credentialing is Important for Healthcare
Almost every patient now does research and
reviews your practice online before starting
their treatment. With the availability of
abundant information, patients have the power to
research their healthcare professional before
committing to them as a patient. Practice
credentials are the key factor for patients to
make the right selection as per their medical
requirements. Medical credentialing is a simple
and effective way to prove that they are
perfectly qualified to perform patient care
services thus, improving the practices
reputation. Additionally, providers and
facilities that are successfully credentialed are
permitted by law to treat all patients,
regardless of their insurance plans. This allows
you to see more patients, further driving
business to your facility and helping the whole
healthcare organization prosper. Reduce Medical
Errors When healthcare providers and practices
get the required medical credentials, it
contributes to the overall safety and security of
the sector. With medical errors being blamed for
100,000 deaths in the United States in 2007, you
can imagine the significance of medical
credentialing in the year 2023. Also, patients
have the right to expect their healthcare
practitioners to know what theyre doing and work
in a safe and approved manner. Medical errors
include miscommunication ordered prescription
errors incomplete patient medical records
overcrowded facilities mismanaged workflow and
many more. As some of these errors are simply
Why Credentialing is Important for Healthcare
errors, by properly credentialing every provider,
you lower the risk of medical error as a
whole. Protects You from Lawsuits Receiving
external payer audit requests is not uncommon in
medical billing. Government insurance companies
like Medicare, Medicaid, and all commercial
insurance companies are quite watchful about
whether they had made correct payments.
Credentialing every single practitioner could
vital in such litigation. If there is a
malpractice claim on a healthcare provider in
your facility, you can help indemnify yourself
and your institution from legal responsibility by
proving that you verified every single one of
their credentials and renewed the verification as
needed. Not only will you shield yourself from
liability, but youll also avoid costly fines
related to legal disputes. Challenges of
Provider Credentialing   The key challenge of
provider credentialing is that this complete
process is complex and time-consuming. Every
single insurance company has its own set of
credentialing requirements and documentation.
Providers who are busy in patient care wont be
able to dedicate that amount of time to filling
out various applications
Why Credentialing is Important for Healthcare
and their follow-ups. Completing a thorough
credentialing process for a single prospective
hire can often take between three to six months
or more. With so much paperwork to gather and the
various institutions to contact and request
records from, weeks can go by with little
progress. Adding to these concerns is the fact
that practitioners need to have their credentials
renewed every two years (except in Illinois,
where the timetable for credential renewals is
every three years). In this article, we tried our
best to answer why credentialing is Important
for healthcare professionals? hope you would
have found it useful. Medical Billers and Coders
(MBC) Can Assist You Medical Billers and Coders
(MBC) can take care of this headache for you and
can also guide you as a provider credentialing
expert. MBC is a leading medical billing company
providing complete revenue cycle services. We can
take over all credentialing tasks like gathering
information cross-checking information choosing
the number of insurance companies to get
credentialed application filling, application
follow up and many more activities leading to
successful credentialing. To be able to
credential more efficiently, see more patients,
grow your business, and earn a higher return,
email us at info_at_medicalbillersandcoders.com or
call us at 888-357-3226.  
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