Credential Process Made Easy

Credential process has always been an integral part of the process of practicing medicine. For anyone who wants to treat patients, it's essential to have a document that proves they are allowed to do so. Yes, it is as simple as that. Credentialing is something that has been going hand in hand with medicine for many years.

There were times when doctors could simply treat first three patients, get a proper certificate and start practicing. Today, credential process is long and time-consuming and can cause headaches if not managed properly. Whether you're a physician opening a practice or just adding a new doctor to a team, you should start the credential process in advance - sometimes even nine months before you're going to see your first patients. If you're not in the plan, you can't work with patients. If you want to earn money, you have to be credentialed. And to get credentialed without problems, you should continue reading the article.

Get All The Papers Together In Advance
Start organizing everything far in advance. Mobilize your staff as soon as you find out the new physician is coming - or, if you're a solo physician, as soon as you decide where you're going to set up practice. Most of the time, you will need a proof of malpractice insurance and a license before you get all hospital privileges. And you need hospital privileges before you get credentialed by the plans. Note that many hospital committees meet quarterly, so you have to complete all paperwork well ahead of time.

As MD of Bakersfield Orthopedic Medical Group Alfred Coppola states, their manager started managed-care and hospital plans credential process well in advance, so that their new spine surgeon had a full appointment schedule on the same day he started seeing his patients.

Keep Track Of Your Documents
Managed-care plans are well-known for accidentally losing physician documents, applications and other stuff. It is strongly suggested to mail your documents as "return receipt requested". This way, you can at least prove that your application was received. Besides, somebody will have to review your application before sending it. Note that if you leave something blank, you paper can be put to the bottom of the big pile.

If you have some problems, speaking to a manager would be better than speaking to a front-line employee. If you spend some time building relationships with an authority, chances your document will get lost are lessened. It always helps when managers can put your face with your name. If your documents get lost, don't panic - consistent follow-up will help you find them. Call them regularly and ask the same person all the time. They will remember your name and your problem.

Don't think there are unimportant details - submitting incomplete information or leaving blank fields will cause delays as payers don't work on any application until you provide them all information they ask for. Note that a common application misses information in four main areas: malpractice insurance, current work status and work history (don't forget the physician's start date), covering attestations and hospital privileges. Besides, payers always have a deeper look at those who have gaps in service that are longer than a month. Provide all possible explanations in your application, so that nobody will have a reason to require additional details.

Don't be shy and look out for peers. An important part of the credentialing process for any physician is to serve as references for colleagues. If somebody asks you, provide turnaround as quickly as possible to avoid delays. Look out for other physicians and help fellow workers to finish the process.
Check your application multiple times to see if you get all the information right. If you submit everything properly, you will get credentialed within 90 days. And if you make a mistake, you will not be able to work with patients.

Whatever you're going to do, never try to modify any documents - be it letters from committees, letters of reference or any other paper. It can be quite tempting, but don't go for it. Chances that you will be caught are extremely high.

Be aware that the physician credentialing process is always frustrating and lengthy. Keep that in mind and don't act impatient or defensive toward the staff you're going to meet. Wait times often can't be controlled by credentialing staff anyway.

Finally, be thorough with your papers. It requires a lot of time at the beginning, but it will save even more time later.

Premier Credentialing Solutions, LLC has the best credentialing and licensing solutions for you and your business; We proudly offer Provider Enrollment & Physician Credentialing, Medicare – Provider Enrollment & Revalidation, Medical Licensure Services, and Full-Service Credentialing For Billers / Billing Companies. Call (800) 455-4773 for a free, no-obligation consultation.