4 Reasons To Care Who Does Your Credentialing


1. Fast Pass to Failure

Done incorrectly, credentialing is the easiest way to ensure your practice doesn’t make it beyond its first year. There are many ways to screw up credentialing and any one of them could prevent you from being able to submit claims. The most common problem we have seen is a delayed participation status due to errors made on the application. All the paperwork can be overwhelming, so it is easy to make mistakes if you are new to it. However, those mistakes can extend the credentialing time period from 4-6 months to 8-12 months. Unless you run a charity, the idea of waiting nearly a year to get paid is a sure way to a fast pass to failure.

2. Privacy Concerns

Shouldn’t it concern you when supplying your personal information if a company is likely subcontracting the work out to someone else? Many billing companies actually outsource credentialing for their clients, so you don't always know who has your information or what they are doing with it. Whenever you are discussing options for credentialing, ask if they will be doing it in-house or even take it a step further and ask to speak with the person who will be handling it. 

3. Foundation of Practice

Credentialing comes first. Before putting in the work to select your billing company, you should already be starting on the credentialing and payer enrollment process for your practice. If you don't, you won't be ready to submit claims upon opening your doors. Payer credentialing is a significant part of your practice’s foundation and your success really does depend on it.

4. The Who & How Much Behind Your Revenue

The payers you are credentialed with dictate which patients you can see and an experienced credentialing company can ensure you participate with all of the right payers for your area. Having someone complete your credentialing that isn't knowledgeable in it could result in either you missing out on patients because you’re not participating with certain payers or missing out on revenue because of poor contracts.