How to Improve the Process of Physician Credentialing

Recognizing well-trained professionals in healthcare services is one of the critical components to achieve the objective for the organization or brand. Generally, consumers have high expectation from healthcare services. Credentialing systems development acts as an important means of gathering accurate information about any physician or provider to identify their training, qualifications and relevant eligibility in the field of practice.

To develop an integrated approach is one of the important steps to approach physician credentialing. As the clinics and organizations are hiring more professionals or physician, it’s becoming chaotic to handle all the complicated details of credentialing systems development.

An unprecedented change is happening in the healthcare industry. The current health policies and economic discussions are being re-ignited. To be efficient, the M&A activity, physician onboarding, and credentialing process have to be managed productively. Make sure when any physician joins, all the credentialing systems development process has been completed with proper documentation along with an electronic signature. Consider capturing each and every penny and this must be an integral part of the cycle. This will take a considerable amount of time to complete.

Make sure whenever any physician joins, he or she must be credentialed to work. All credentialing documentation should be collected and reported right away which includes primary source verification and electronic signature as well. You can use a Microsoft Excel spreadsheet or any credentialing software to track if any document is missing. This will help in monitoring the provider’s enrollment status. This data should be reserved in a cloud-based repository so that it can be available for review whenever it is required!

Even if the administrative processes are in right place, unexpected things can happen anytime. The provider may miss the deadline for submitting the documents or the department could lose track because of peak time or busy days. In all of these cases, the provider may get temporary prerogative. Focus on enhancing the provider enrollment using the cloud system. Because it is done without the expense of installing, executing and handling the server’s software.

Another step is to check whether your software tracks any particular key performance factors or indicators. Otherwise, take time to track them manually or you can use Microsoft Excel. Aim to establish performance metrics and improve them consistently. Using best practices as early as possible should be the main focus. Because the enrollment process cannot be delayed. The documentation should be ready as the credentialing process goes on. Stop assuming that everything is in place already. Double check if needed. Take real-time snapshots of what’s really going on there and what needs to be done.

There has been greater emphasis on credentialing consistently. It is a priority for the C-Suite executives nowadays. Several hospitals don’t realize the potential of setting up credentialing systems and many hospitals don’t have the expertise or budget to implement it successfully. Although the process of credentialing and enrollment is a highly complicated and challenging task, with proper resources and adequate processes, the entire credentialing and enrollment life cycle can be managed successfully.

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