New Year’s Resolutions for Providers and Practices
Posted on Friday, December 11, 2020
The year is coming to an end and it’s time to plan for a successful year ahead! Have you set any New Year’s resolutions for your practice?
These New Year’s resolutions for providers and practices can help you accomplish your goals in 2021 and beyond:
Conduct a Health Plan Audit
An annual health plan audit is critical to the success of your practice as it protects it from liability issues, boosts front desk collections, and helps keep providers from being deactivated by payers and having claims denied.
CredentialingOne offers a health plan audit service that determines whether your practice and providers are compliant with all your payers’ contracts and the insurance plans in which you’ve enrolled. For example:
- Have you notified payers of a provider’s termination, resignation, or retirement within the timeframe required by the contract?
- Have your providers opted in to any new plans added by a payer?
- Have your providers opted out of any new plans added by a payer in which they do not wish to participate?
Start the year off right with a health plan audit to ensure your provider roster is current and all providers are participating in the correct plans.
Reduce Reimbursement Denials
In addition to an annual health plan audit, it’s essential to monitor your providers’ credentials throughout the year. Credentialing errors, such as expired certificates or missing CE credits, lead to reimbursement delays, denials, and underpayments.
Any time a provider or practice fails to accurately complete/update their credentialing, provider enrollment, or hospital privileging applications and documentation in a timely manner, they risk a significant loss in revenue. Unfortunately, this is all too common as the credentialing process is complex and it is very easy for items to fall through the cracks or to overlook important tasks like following up on applications.
Allowing a team of experts to handle all provider credentialing and provider enrollment work for you can help prevent claim denials and save you a lot of time and money down the road. CredentialingOne completes this work quickly and correctly, so that providers are credentialed and recredentialed with payers as soon as possible to avoid any breaks to the revenue stream.
Furthermore, we keep track of providers’ and practices’ expirables and our real-time, automated messaging alert system notifies you of any upcoming expiration dates so that you don’t miss a credentialing deadline that would result in denied claims.
Improve Work/Life Balance
Providers spend an alarming amount of time on EHR and desk work. On top of this, credentialing and provider enrollment are complicated, ongoing, and time-consuming processes that usually take longer and are more involved than the clinician expects. Completing just one application to credential a single provider with one payer takes about 8-10 hours; and most providers enroll in at least a dozen different health plans (each with its own unique application process).