How To Handle Delays In Credentialing & Enrollment?

Are you worried about what happens in case of delays in Credentialing & Enrollment? Want to know how to best handle a situation of delay to avoid further issues? Read this to understand the top reasons for delays in Medical Credentialing and how you can handle them if they do unfortunately arise.

Importance Of Credentialing & Enrollment

Credentialing & Enrollment are essential processes for Healthcare Providers, as they establish the qualifications of a provider to practice within the healthcare industry. Moreover, they ensure that healthcare providers,

• receive their reimbursements on time
• avoid the possibility of claim denials (It hurts, after working so hard to serve the patients!)

In an ideal world, the process should be smooth for everyone capable of providing healthcare services. But unfortunately, the rigorous verification method and a lot of paperwork involved make the process tedious, cumbersome, and prone to errors.

Causes Of Credentialing & Enrollment Delays

Prevention is always better than cure. Who knows it better than those providing medical services?

Before we get on how to handle the delays, let’s have a quick look at the top reasons which might complicate your Medical Credentialing process

1. Inaccurate or incomplete information from Providers
2. Insufficient staffing in Credentialing departments
3. Insufficient training of personnel
4. Poor communication within the organization
5. Inadequate IT systems and processes
6. Lack of understanding by Providers on the Credentialing process
7. Excessive paperwork and documentation needed for Credentialing & Enrollment
8. Difficulty obtaining the necessary documents or verifications
9. National Provider Identifier (NPI) issues
10. Long wait times for background checks, licensure verifications, and other requirements

To read more on each of the above factors and understand in detail, you can refer to the Top 5 reasons causing delays in Credentialing & Enrollment 

Strategies To Minimize Delays In Credentialing & Enrollment

1. Automate the process with a Credentialing software
2. Utilize established Credentialing services
3. Have a clear and concise Credentialing policy within the organization
4. Contain all information within an easily accessible system
5. Streamline internal processes such as communication, documentation, etc.
6. Ensure proper staffing in the Credentialing department with adequate training
7. Stay updated with regulatory changes and industry standards
8. Monitor the turnaround time for each Credentialing & Enrollment process
9. Establish a system of checks to ensure accuracy
10. Offer incentives or rewards to providers for timely compliance

By following these standard strategies, you can minimize the chances of delays in Medical Credentialing & Enrollment and make sure that your Healthcare Providers are Credentialed & Enrolled as soon as possible.

How To Handle Delays In Medical Credentialing?

Despite taking care of all the above-mentioned strategies to avoid delays, it has come to test your patience. So, first of all, be patient. Do not panic.

With the right guidance and regular follow-ups, you will have your Credentialing done. Let’s have a look at ways of handling the delays and how to support the other parties involved in the process.

• If you find yourself facing delays in completing the process, it is important to keep all the stakeholders involved on the same page. This will ensure that everyone has a clear understanding of their roles and responsibilities and can work together towards resolving the issue faster.
• Don’t let the dominoes effect strangle you. There should not be delays from your end. In case of queries from insurance companies or Medicare or Medicaid, try to answer promptly.
• Support your Credentialing partner. It has to be collaborative work. Once again, reply promptly. Ensure your documents are accurate.
• Cooperate with organizations asking you for additional information. Answer exactly and afresh, if required. They might not refer to previous mail threads.
• Follow-up as often as you can. When you partner with a Credentialing expert, they will do this for you to ensure the quick processing of your application.

Finally, remember that Credentialing & Enrollment is a crucial processes for the success of your Organization. If the process is delayed or not carried out accurately, it can have serious repercussions on both Providers and patients alike. It’s always better to be proactive than reactive when it comes to this critical aspect of Healthcare Management.

If you are still feeling stuck, feel free to reach out to us. We will ensure a Credentialing specialist handhold you out of your troublesome situation.

At Apaana Healthcare, we hold the expertise to provide end-to-end Credentialing & Enrollment Services.