Reasons Why You Should Outsource Your Medical Credentialing ImageA study from Health Administrative Partner (HAP) reveals that healthcare providers are likely to outsource their credentialing services. Medical credentialing serves as a foundation of trust and faith between patient and provider. The purpose of this blog is to outline the reasons for outsourcing medical credentialing. These reasons, such as faster turnaround times and reduced administrative burden, bring direct benefits to the healthcare facility. Let’s start this journey together.

Reasons to Outsource Medical Credentialing

To help you make a decision about outsourcing medical credentialing, some crucial reasons are listed below:

Reasons to outsource Medical credentialing

1. Swift and Efficient Credentialing Process

1.1 Administrative Burden is Reduced

Outsourcing medical credentialing lowers the administrative burden. Credentialing involves an extensive amount of paperwork, data entry, and document verification.

A team of professionals is required to check the credibility of the providers. They make contact with other regulatory bodies, such as insurance companies. This whole process is time-consuming and puts an extra burden on the healthcare staff.

By outsourcing the whole process of credentialing to a team of professionals, you can save your facility from a hectic routine. The shift from in-house credentialing to outsourcing allows the providers to refocus their direction on their primary duty, i.e., patient care. This improves the efficiency and overall quality of the healthcare facility.

1.2   Higher rate of  Turnaround 

Outsourcing credentialing to a third entity can expedite the whole process, resulting in faster turnaround times. Third-party experts are aware of all the requirements of the procedures. Thus, they have already communicated with providers and insurance companies. 

If healthcare providers try to manage the whole process internally, they might face some issues related to delays in credentialing approvals. In-house credentialing requires a longer timeframe as compared to medical credentialing services.

2. Expertise and Accuracy 

2.1 Specialized Knowledge

Medical credentialing is a complex procedure that requires a genius mind with specialized knowledge of the field. This is because every insurance company has its own set of regulations and guidelines to follow. An average mind can’t manage to hold every detail of the process.

 By outsourcing to a credentialing service company, you have entered the world of professionals whose major part of lives revolves around medical billing and credentialing services. Their in-depth knowledge helps your facility meet the standards of the regulatory bodies.Thus, your facility gets approvals swiftly.

2.2 Minimize the margin of Errors and Rejections

Outsourcing medical credentialing can minimize the margin of errors in the documentation, resulting in a significant reduction in delays and rejections.

Errors in the process are common if a non-professional team tends to handle it without any expertise. Rejections could be due to incomplete submission of applications or to any other inaccuracy in the documents. This is because the in-house team is not fully aware of the details of the process and is unable to identify the potential errors. This leads to financial losses, such as delays in reimbursement.

Grand view research report about the demand for medical credentialing

3. Regulatory Compliance

3.1 Staying Current with Regulations

Staying updated on all current changes in the policies and guidelines of insurance companies is a great challenge. It demands standard knowledge, commitment to time, and compliance with the latest guidelines.

Outsourcing medical credentialing offers a solution to this problem. They have a dedicated team and a robust system to adapt to new changes. They make sure that the credentialing process is aligned with the most recent guidelines and thus minimizes the risk of compliance-related issues.

3.2  Reducing Risk of Non-Compliance

Non-compliance with the guidelines of regulatory bodies can result in fines, claim denials, legal penalties, and lifelong damage to the reputation of the provider. This can result in some serious consequences as well, such as a loss of accreditation.

Medical credentialing companies have updated knowledge of all the relevant regulations. They reduce the errors that could result in non-compliance. By adopting this method of outsourcing the whole process, the healthcare facility safeguards itself from financial as well as legal repercussions.

4. Cost Savings

 4.1 Reduced Overhead Costs

In-house medical credentialing directly affects the monthly expenses of the healthcare facility. Credentialing staff demands proper office space, training, and salaries. These extra expenses can be a real challenge for many facilities.

Outsourcing means no special arrangement is required for in-house staff. If we compare the in-house cost with the fee given to credentialing, the result could be obvious. Outsourcing is economical and reduces the administrative burden. The saved resources can be utilized for patient care.

4.2 Improved Revenue Cycle

A professional approach to dealing with medical credentialing directly affects the efficiency of the revenue cycle. Prompt documentation submission results in an accelerated revenue process. When there is no error found, there is no room for rejection and delays. This leads to improved cash flows and timely reimbursement.

5. Focus on Patient Care

 5.1 Enhanced Patient Experience

Outsourcing places a substantial focus on the health of patients. Healthcare providers are not burdened with extensive paperwork, document submission, verification, or compliance with regulatory bodies. The transformation from in-house load to outsourcing brings more time and attention for patients.

The overall experience of the patient in the hospital is enhanced. The provider has more time to spend with the patient and has more interactions and communication with them. This not only satisfies the patient but the provider will also become his first priority for health checkups.

6. Scalability

 6.1 Handling Growth

With the growth of healthcare practice comes the problem of accommodating the evolving needs of the growing facility. Credentialing companies are well-equipped to handle these changes and mold themselves according to evolving demands. Scalability allows the healthcare facility to expand its services and hire new providers without being administratively burdened.

Report of (MGMA)

Final Words

The decision to outsource medical credentialing directly impacts the patient’s healthcare. The advantages range from a streamlined and efficient process to expertise and accuracy. Regulatory compliance, cost savings, a focus on patient healthcare, and scalability are some more valid reasons discussed in this blog. Outsourcing frees the providers from the administrative burden. This helps them to fully focus on their primary duty, i.e., patient health.

Choose Medheave as your Medical Credentialing Company

Choose Medheave as your medical billing and credentialing company for a seamless credentialing experience. By partnering with us, you don’t need to worry about compliance with regulatory bodies and will get efficiency and accuracy in the credentialing process. Contact us today and elevate your practice with Medheave, the trusted hands of professionals.

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