In the field of medical billing, there are so many moving parts that need to be considered at all times. One of these components is medical credentialing, which is the process of validating the credentials of medical professionals to ensure that they’re truly capable of providing medical services to patients. During medical credentialing, there are many mistakes that could be made, and we want to go over these mistakes today so that you can prevent them in your own practice.
Letting Providers Begin Before Verifications are Done
The reason for medical credentialing to be done is to make sure that medical providers are able to provide sufficient care to patients. If you allow providers to work with patients before verifying their credentials, your patients could end up receiving medical services from someone with insufficient qualifications. This is a huge risk, as patients could receive unsatisfactory medical services, which can put the patients in danger or, at the very least, make patients not want to seek medical services from your facility in the future.
Not Re-credentialing Your Current Medical Providers
It can be easy to forget about re-credentialing if you don’t keep track of when it needs to happen. When a medical provider has their credentials verified, that verification only lasts for a fixed period of time. You’ll need to have those credentials re-verified regularly to make sure that your medical providers are still capable of providing quality care.
You should get reminders between 90 and 180 days before credentials expire. This will give you the time you need to ensure that your medical providers can complete the needed steps to become re-verified.
Submitting Inaccurate or Incomplete Applications
Healthcare providers have to submit a lot of information on enrollment applications and medical credentialing. Sometimes, a mistake that can happen is that some information could be left blank, or some information could be incorrect, like contact information that isn’t current. In situations such as these, payers will send the credentialing packet back. Then, those healthcare providers will have to edit the information in that packet to make sure that the information is complete and accurate.
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