5 Tips for Simplifying the Credentialing Process

November 21, 2021by Sherana Tucker

Although physician credentialing can be a time-consuming process, it is a necessary one to promote better patient care by providing standards for medical providers.

The industry expectation is to verify providers’ professional work history, licenses, education, and background, but the process of organizing and verifying a doctor’s professional records can become a source of frustration for physicians and their practice.

It is possible to reduce the number and severity of delays and other nuisances that come with credentialing. Consider following the five steps below, which are effective and easy to implement.

1. Start the Credentialing Process Early

Although hospital credentialing can typically be done within 90 days in most scenarios, it is advisable to give it at least 120 days. You may not need the 30 days of extra time, but beginning the credentialing process at least 120 days before your start date will provide a cushion for unexpected delays. It is important to remember that you are working on someone else’s clock, and each facility can have its own internal timeline for credentialing and application processing.

CredentialPro Tip: Do not delay! You may not need the extra 30 days of processing time, but it could come in handy.

2. Carefully Proofread Your Application

About 80% of applications are incomplete or have outdated information. Incorrect information or forgetting to fill out all of the required fields on your application is a preventable mistake that will delay processing.

The following four fields are most commonly overlooked or likely to contain incorrect information.

The physician’s work history and current employment, with the scheduled date of starting work at your practice listed.
Information about malpractice insurance, such as type and amount.
Which colleagues can cover for the physician.
Verification of authenticity by qualified witnesses.

CredentialPro Tip: Taking a few extra minutes to proofread your application before submission, can save weeks of backtracking incorrect information.

As a clinician, your primary focus is the patient. So, let us help you obtain the approval to deliver their care faster!

3. Keep Up to Date with CAQH Requirements

The Council for Affordable Quality Healthcare (CAQH) runs a uniform credentialing program. Adopting the CAQH profile helps you stay in line with current credentialing requirements and can make the entire process more efficient. Physicians and medical professionals that regularly update and attest with CAQH find credentialing and re-credentialing much easier.

CredentialProTip: Adopting the CAQH profile helps you stay in line with current credentialing requirements.

4. Know your State’s Requirements

Did you know that some states have laws that require the physician credentialing process start in a timely fashion? You will also need to check whether the state has reciprocity regulations (if you are credentialed in another state, you may be able to go through the process more quickly in the state you are applying to), which can help expedite the credentialing process. Your state Medical Group Management Association can assist in ensuring you are using your state’s standards to your advantage.

CredentialPro Tip: Knowing your state’s requirements will help expedite the credentialing process.

5. Consider Outsourcing to Professionals

Credentialing can be tedious and frustrating, particularly if you don’t have all the information you need upfront. However, it is necessary and unavoidable. It takes a professional to navigate this realm within specific time constraints, regulatory requirements, and with minimal errors. CredentialPro will cut through the red tape and be your professional guide in ensuring a smooth credentialing process!

Credential Pro Tip: Request a consultation with a CredentialPro specialist and become one step closer to obtaining your hospital privileges.

Sherana Tucker

655H Fairview Rd, Ste 301 Simpsonville, SC 29680

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