Keeping the Medical Practice revenue flow intact and evergreen requires constant effort from physicians and Medical practices. Overcoming financial lags owing to claim denials and keeping up with the ongoing changes and regular updates are prerequisites for any practice to ensure the monthly collections and claim reimbursements are intact. There are various reasons why a claim can get denied and affect your cash flow, physician credentialing is one among them. Timely Provider Credentialing and keeping the credentialing privileges active are mandatory to avoid related claim denials.
Why is Physician Credentialing Crucial?
Physician Credentialing is crucial as they affect the financial aspect of the Medical Practice or the Physician greatly if not valid. Without proper credentialing Physicians can not send patient claims to the payor. Expired or invalid Physician Credentialing can lead to claim denial and loss of reimbursement. Until the Medical Practitioners’ Credentialing are complete and active the physician or practice might not get their due payments from the insurance carrier.
Lack of proper Credentialing or Active Credentialed status is equivalent to non-participating or Out- of – Network providers. Therefore it is of paramount importance for the Physicians to be in the network with active credentials to ensure they are linked to all the payors whom they would like to bill for.
Tricks to Avoid Credentialing Related Denials:
- Do a complete audit of your denials to analyze if the lack of proper provider credentialing is a reason. If yes, then take adequate steps to fix them at once before it affects your bottom line.
- Keep a checklist of all the payors you are in-network with or credentialed with and have a streamlined approach to have them checked and re-credentialed on time.
- Set reminders to notify ahead on Re-credentialing requirements so you have ample time to get the required supporting document for application and submission on time
- Keep your CAQH profile up to date always making any changes or updates as and when required
- Physicians getting first-time credentialed with a payor should be well prepared with all required documents to be submitted along with the application for on-time processing and enrollment. Incomplete and inadequate information or documents can lead to unnecessary delays and affect claims reimbursement
- Investing and leveraging on credentialing software can reduce human errors and delays. Medical groups or practices needing frequent credentialing support rely on these upgraded technologies to pace up
- Outsourcing to Credentialing Professionals of Medical Billing Companies with an expert team on Physician Credentialing is the most lucrative method.
Benefits of Outsourcing Provider Credentialing:
- Access to top Physician Credentialing experts
- Effective and Efficient processing of each and every credentialing application with utmost care to ensure they are clean and clear on the first submission to avoid unwanted delays and hassles.
- On-time Credentialing and Re-credentialing to ensure your payments are intact and unaffected avoiding claim denials due to lack of credentialing requirements.
- Time advantage and Advanced Support yield more scope for patient care
- Cost-effective and Stress- free
- Upgraded tools and technologies processing your Credentialing application proficiently.
- CAQH updating and Re-credentialing reminders and Support
- Reduces Claim denials due to lack of Provider Credentials
About MGSI
MGSI is a national Medical Billing and Revenue Cycle Management Service provider located in Tampa, FL. With over 27yrs in the Healthcare Industry MGSI provides various scopes of services right from End to end billing services and other services like Physician Credentialing, Practice Management, Healthcare Contracting, etc. MGSI has expertise in handling credentialing Services with different payers and our Physician Credentialing team are experts in handling each application adequately to meet the elected insurance carrier’s requirements. To know more about MGSI and our services, call 1-877-896-6474 or log on to Medical Physicians and providers Credentialing Services | MGSI (mgsionline.com)