Medical credentialing is a formal process to verify that medical staff such as physicians and nurses are both certified and trained to provide healthcare services to patients. In order to maintain the highest standards of patient safety and care, it’s important to have medical credentialing experts who do all extensive paperwork and verification.
Medical enrollment also commonly known as provider or payer enrollment is the process through which a healthcare provider gets inclusion in the health insurance network. Once a healthcare provider becomes a part of a health insurance network, he is allowed to cater to patients who carry insurance from the same health insurance network.
The process of physician credentialing usually starts with an application. Every healthcare facility has a different application so the physician needs to get credentialing for each facility he will be working in. Once he’s done with submitting the application, he needs to provide various supporting documents such as his medical license, DEA number, board certification, and other educational and professional work documents. Then a credentialing specialist will analyze and verify all the submitted documents. Once he’s done with verification, the matter will be moved to department heads and hospital boards who then approve or disapprove the physician’s employment. In some cases, physicals are also asked to reapply and provide documentation for re-credentialing.
Medical credentialing is an essential part of revenue cycle management and it offers you various benefits. First and foremost, credentialing helps you in building a relationship of trust and confidence with your patients that will eventually help you in making your reputation better against your competitors. In addition, medical credentialing greatly helps in quality assurance and establishing a higher level of professionalism. Moreover, hiring a good provider credentialing service like Medtech Providers help you in reducing the risk of legal issues and minimizing the chance of errors.
