CredentialingOne Blog

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:

Blocks with healthcare icons are stacked in a pyramid and the blog title appears: New Year’s Resolutions for Providers & Practices

Set yourself up for credentialing, provider enrollment, and revenue cycle success with these New Year’s resolutions for providers and practices.

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.

A clock and stethoscope are shown and the following statistic appears: 8-10 hours per application is the average time it takes to credential one provider with one payer.

Outsource credentialing to improve work/life balance and prevent clinician burnout.

Improve Work/Life Balance


Clinician burnout is a major concern for providers and practices alike and is often the result of too much paperwork, administrative burdens, and working long hours.

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).

Make preventing clinician burnout a top goal for your practice this year – outsource credentialing and give your providers more time to care for patients and their own well-being!


Keep Your New Year’s Resolutions with CredentialingOne


CredentialingOne can help you reach these goals and more. Contact us to learn more about our services, and start the credentialing process with us before the new year to take advantage of our end-of-year discount for qualifying customers!


By Stephanie Salmich

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