What is Centralized Credentialing and What Benefits Will it Provide?

In the past, healthcare organizations in the state of Ohio were required to complete six unique credentialing processes any time they wanted to bring on a new provider. Completing a single credentialing process can be a complex and time-consuming task – having to complete a credentialing process for all six of the Managed Care Organizations (MCOs) that make up the Ohio Department of Medicaid (ODM) has been the stuff of nightmares for many Ohio healthcare organizations.

Thankfully, the ODM has recently announced a promising new change to its credentialing process that is designed to improve patient care by reducing administrative burdens for Ohio’s Medicaid providers. Thanks to this new centralized credentialing system, healthcare organizations in Ohio will no longer have to complete six separate credentialing processes when bringing on a new provider. In this article, we’ll cover everything you need to know about the ODM’s new centralized credentialing system including how it differs from the outgoing system and the exciting benefits that it will provide.

The Next Generation of Ohio’s Medicaid Managed Care Program

There’s no denying the fact that the ODM’s outgoing system for credentialing new providers was unnecessarily complex and cumbersome. The good news is that the ODM has recognized this fact and is now in the process of implementing the next generation of Ohio’s Medicaid Managed Care Program.

Under this new program, healthcare organizations will be given access to an ODM provider network module that manages credentialing for all six of Ohio’s MCOs. Rather than having to complete credentialing for all six MCOs separately, healthcare organizations can now complete a single credentialing process within the ODM provider network module that will count for all six MCOs and eliminate the unneeded redundancy of the outgoing system.

The Benefits of Centralized Credentialing

The first and most obvious benefit of Ohio’s new centralized credentialing system is the fact that it eliminates the need for organizations to complete six separate yet nearly identical credentialing processes each time they want to bring on a new provider. Completing a single credentialing process is complex and time-consuming enough as it is, and it’s safe to assume that every healthcare executive in Ohio is excited about no longer needing to complete this process six separate times for each provider.

In addition to drastically reducing the administrative burden of organizations serving Ohio Medicaid members, though, there are several other benefits to the ODM’s new centralized credentialing system that are worth considering as well. The first of these benefits is the fact that the credentialing verification organization (CVO) Maximus, Inc. will now maintain NCQA accreditation requirements for Ohio’s MCOs in addition to serving as a single point of contact for providers throughout the credentialing and recredentialing processes.

Another key benefit of the ODM’s new system is that it will further reduce the administrative burden of healthcare organizations and providers by identifying credentialing work that has already been completed and eliminating the need for individual providers to engage in multiple credentialing processes. This is accomplished by establishing delegate agreements with hospital systems as well as a delegate review process.

In more ways than one, the ODM’s centralized credentialing system is set to substantially reduce the burden of healthcare executives and providers in the state of Ohio, freeing them up to spend more time focusing on improving patient care and growing their business.

How Bikham Healthcare Can Help You Navigate Ohio’s New Centralized Credentialing System

The ODM’s centralized credentialing system is designed to make credentialing new providers much simpler and less time-consuming for Ohio’s Medicaid providers. However, this new system still comes with plenty of complexities.

If you would like assistance credentialing new providers under this new system in the most efficient and affordable way possible, we at Bikham Healthcare are able to help. By utilizing the latest credentialing software combined with our team’s decades of combined experience enrolling and credentialing healthcare providers, we are able to help healthcare organizations in Ohio navigate this new credentialing system in a way that is completely hassle-free. In fact, when you choose to work with Bikham Healthcare, you can look forward to having the responsibilities of provider credentialing completely taken off the shoulders of you and your staff. To learn more about how Bikham Healthcare can help you navigate Ohio’s new centralized credentialing system and help you get started credentialing new providers in a far more efficient and cost-effective manner, be sure to contact us today!

Contact us for a Free Quote

By clicking submit, you agree to our Terms and Conditions and Privacy Policy.

By providing a telephone number and submitting the form, you are consenting to be contacted by SMS text message. Message and data rates may apply. Reply STOP to opt out of further messaging.