The Cost of a Credentialing Mistake

It is said that “Mistakes are always forgivable, if one has the courage to admit them.” This is, however, not true if mistakes are made when practitioners are on-boarded, credentialed/re-credentialed and enrolled into payer plans. These mistakes impact facilities, practitioners, patients and bottom lines. 

Staff spends too much time completing documents

It is said that “Mistakes are always forgivable, if one has the courage to admit them.” This is, however, not true if mistakes are made when practitioners are on-boarded, credentialed/re-credentialed and enrolled into payer plans. These mistakes impact facilities, practitioners, patients and bottom lines. 

Staff spends too much time completing documents

Credentialing/re-credentialing practitioners is a labor intensive activity and it’s not only Medical Staff professionals who feel the pain. Practitioners also feel the pain of taking hours over the course of days to sign, submit their credentialing information and answer attestation questions. Practitioners would rather spend this time treating patients, which also translates into increased revenues for a facility, and spending less time having to deal with mounds of paperwork.

The impact of errors

Mistakes on credentialing applications can mean delays with credentialing, privileging and enrolling practitioners into plans. It also means staff needs to spend time investigating and correcting mistakes and/or omissions.

Cost of Delayed Enrollments

Credentialing processes that rely on paper have a higher chance of delaying enrollments. This can result in a practitioner not being able to accept a patient or having a claim denied.  Enrollment delays are costly and many times they can be avoided.

Patient Impact

Ensuring practitioners are enrolled or re-enrolled into plans in a timely manner is critical because patients are also impacted by delays. Consider the frustrated patient who’s just been informed that their provider is no longer enrolled in their plan.  Or consider the patient whose pharmacist has just informed him or her that their prescription can’t be filled because their doctor’s DEA license expired.

Employee’s Expectations

One less obvious and often overlooked cost of credentialing errors is the impact these can have on the morale of the people who matter most, your employees.  Medical staffing professionals strive for excellence and their organizations expect them to operate at the highest standards. When an organization proactively prevents costly mistakes this results in wins for everyone – staff, providers, and the organization as whole.  Leveraging the right tool(s) can be instrumental in being able to meet everyone’s high expectations.

Financial Implications

Administration personnel spend excessive amounts of time completing paper applications, practitioners spend inordinate amounts of time signing documents, credentialing specialists laboring to investigate and rework applications, enrollments are delayed…..the list can go on and these all have a financial impact.  

There is better way

Eliminating paper, automating activities and streamlining provider onboarding, credentialing and payer enrollment process cuts down on costly errors and saves significant dollars, Can credentialing mistakes still occur? Yes, but with I-Enroll these can be kept to a minimum.  It’s the solution that more organizations are now looking towards to bring their provider management capabilities into the 21st century.

If you would like information on how your organization can improve all aspects of how it manages and maintains its provider information and documentation, contact one of our I-Enroll Evangelists today or call us at 732-658-0072- Extension 303.   

Reach out and we’ll shed light on how I-Enroll reduce errors, eliminates paper, streamlines processes, increase productivity and improves bottom lines.