Seven Provider Credentialing Best Practices

Provider credentialing can often be a complex and time-consuming process. However, it’s also a vital process that every healthcare practice must complete each time they hire a new physician. In this article, we’ll take a look at a few provider credentialing best practices in order to ensure that you are able to go about the process of provider credentialing in the most efficient and effective way possible.

Best Practice #1: Set aside Plenty of Time for the Process

Provider credentialing is a process that can take much more time than many healthcare practices realize. If you don’t set aside plenty of time for thoroughly credentialing the new physicians that you hire, you may find yourself in the unfortunate scenario where your physicians are unable to work until the process is completed. To avoid disruptions such as this, it is essential to set aside plenty of time for completing the provider credentialing process.

Best Practice #2: Familiarize yourself with State Laws

The various laws regarding provider credentialing can often vary dramatically from state to state. They can also vary dramatically depending on the exact scenario that you are dealing with, including scenarios such as hiring a physician who intends to practice telemedicine, hiring a physician who comes from another practice within the same state, and more. Given all of these variations, it is important to thoroughly familiarize yourself with all provider credentialing laws and requirements in your state before you begin the credentialing process. The Federation of State Medical Boards and your state chapter of the Medical Group Management Association are two excellent resources to use in order to ensure that you are following all appropriate laws and standards.

Best Practice #3: Double-Check for Errors

Even the smallest errors such as a typo or missing piece of information can upend the provider credentialing process and force you to start over again from the beginning. In order to avoid the costly delays that even a minor error can create, it is essential to check and double-check each form that you complete before you submit it.

Best Practice #4: Make use of Automation Software

Many of the forms that you are required to fill out during the process of credentialing a new provider will be populated with much of the same, basic information. One great way to save time while also helping eliminate room for error, therefore, is to make use of automation software that will automatically populate your forms with all standard information. Thankfully, software solutions designed to help automate the provider credentialing process are readily available and are a great way to cut down on some of the time and hassle associated with credentialing new providers.

Best Practice #5: Perform Criminal Background Checks

A criminal background check likely isn’t the first thing that comes to mind when you think of provider credentialing, but it is an important part of the provider credentialing process nonetheless. A criminal background check can help ensure that there aren’t any quality of care or safety concerns associated with the new physician that you are bringing on board and should certainly be part of your healthcare practice’s onboarding process.

Best Practice #6: Pay careful attention to Quality of Care

Given the fact that the Affordable Care Act (ACA) measures payment based on quality of care, quality of care is now a more important factor to consider as part of the credentialing process than ever before. In addition to damaging your practice’s reputation, hiring a physician who has a history of poor outcomes can now damage your practice’s bottom line as well. With this being the case, it is essential to carefully consider criteria such as patient outcomes and quality of care as you go about credentialing a new provider.

Best Practice #7: Organize your Files

Credentialing a new provider is a process that entails a lot of files and documents. If you would like to make the process as efficient as possible, therefore, it is important to develop a well-organized system that makes it easy for you to find the documents you need in a timely manner. Since most credentialing organizations now require electronic document submission, staying well organized is likely to mean developing an efficient electronic filing system. However, if you are working with paper documents, it’s important to keep them well organized as well.

Let Bikham Healthcare help you through the Process of Credentialing new Providers

At Bikham Healthcare, provider credentialing is our specialty and expertise. For years, we have helped healthcare practices across the country eliminate the many hassles associated with credentialing new providers by taking the burden of provider credentialing off of their hands. If you would like to ensure that your new providers are credentialed in a way that is timely, effective and fully compliant, and free of any effort on your part then working with the provider credentialing professionals at Bikham Healthcare is the perfect solution for you.To learn more about our industry-leading provider credentialing services, feel free to contact us today. A friendly and knowledgeable customer service representative will be happy to answer any questions you might have about our proven provider credentialing process and help get you started enjoying a service that is sure to save you and your practice time, stress, and money.