7 Steps to Easy Physician Credentialing Credentialing — also called Physician Credentialing, is a process of formal verification of a physician’s educational documents, work record, license and practice history. Employers and payers review this information and determine whether the physician should be hired, or in the case of a payer whether the physician will be permitted to bill that insurance carrier. Without successful credentialing, reimbursement for medical services can be delayed and, even, denied.
MAKE ALL YOUR DOCUMENTS READY
Collect all the required documents including education information, license information, certifications, work history, malpractice liability certificate and others. Physicians should know that all these documents along with the personal information, will be used every time they would apply for getting registered.
Hire Credentialing Expert
Whether you are applying to an employer or submitting your application to a payer, hiring a professional credentialing service provider would make the process hassle free, and it increases the success ratio manifold. A professional credentialing expert would keep track of all your applications, send reminders and would timely follow up.
Allocate Proper Time
Getting registered with payers has to coincide with their timeline, and most of the times the credentialing process can take around 90 – 120 days. In any scenario, physician practices should allocate 150 days as estimated turnaround time. However, a proper handling can complete it in less time.
Keep CAQH Profile Complete
CAQH ProView, is a uniform credentialing program which has been widely used by payers and employers to cross-check and verify physicians’ data. Keeping personal and professional information updated on the CAQH portal can save time, expedites the acceptance process and physician can share it with multiple organizations.
Maintain a Checklist
Maintaining a checklist of the requirements and the submitted applications status with dates makes it a lot easier to manage. It becomes very convenient to access all your personal information including important numbers, passwords, tax ID, license number, professional and educational documents at one place. The checklist reduces the chance of missing any important requirement.
Keep Contact Information Upto Date
Physician credentialing is a long process and can take up to many months, and during that period there can be instances where an instant contact is required to fulfill an immediate requirement. Physicians should instantly communicate any change in their address or contact number to their credentialing handler.
Timely Follow up
The credentialing process can sometimes involve multiple submissions which can be caused by any change in the state law or because of any new requirement by the application reviewer. It is important to properly follow up every application and answer the queries in time; this would make the progression smoother.