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Why aren’t you outsourcing the credentialing and provider enrollment process to a professional credentialing company?

For today’s practicing provider’s, there is so much to do and the “business of the practice” needs special attention. Keeping abreast of the multitude of new coding requirements, billings standards, payor enrollment and payor policies, credentialing, contracting and federal mandates can be expensive and overwhelming.

It is becoming common for medical practices to outsource their billing and credentialing to outside service providers but medical billers and billing companies can also benefit from outsourcing this task!!  As a medical biller and billing company, your primary focus should be on managing your clients claims, submitting clean claims for your clients, and collections for your clients!  By outsourcing the necessary, but time consuming and daunting task of provider enrollment and credentialing you will free up your staff to focus on generating revenue for your clients!

So why should you outsource this segment of your current process to an outside service provider?

Or if you don’t provide this service to your clients, why should you outsource this process to an outside service provider?

Hiring an outside credentialing company has proven to be a cost-effective solution for various reasons. First, it reduces your overhead and it also eliminates the headache of finding qualified personnel and the time spent training them – not to mention that you can maximize all of the medical billing staff that you have to increase collections for your clients.

Apart from the monetary savings, outsourcing can improve your efficiency and enhance employee utilization within your office, thus increasing reimbursement levels. A medical biller’s time and effort should be directed towards reimbursement, not towards the struggle with insurance companies in trying to get contracted.  Remove the administrative burden and minimize the financial impact by outsourcing your provider enrollment and credentialing function to a professional credentialing agency.

Below are some of the benefits of outsourcing your Credentialing and Payor Provider Enrollment needs:

  1. Reduce and control operating costs: Typically, outsourcing reduces costs by 30-40%.  Once you outsource your provider enrollment needs, a lot of administrative and operational costs reduce automatically – paperwork, labor costs, advertising and interviewing costs, training costs, overtime costs, employee benefits costs and paid time off costs to name just a few!
  2. Leverage experts in the field: Don’t miss critical items that could impact the timeline to getting providers enrolled, rely upon the experts and specialists in this field.
  3. Leverage the efficiency and effectiveness of specialists: Have them work through the red tape! When you outsource, provider enrollment and credentialing experts integrate their workflow with that of your staff. They work closely with you and your staff, keeping you updated on the status of contracts.  They are knowledgeable and trained to manage your client’s payor enrollment needs quickly and efficiently.
  4. Eliminate administrative errors: Errors can result in delays to successful enrollment.
  5. Eliminate denied claims: Denials can impact your ability to maximize revenue for your clients. Claims that are denied due to improper credentialing can be avoided by outsourcing to an experienced credentialing agency.
  6. Optimize billing and collections: Focus your billing team on what they do best! Don’t leave money on the table. Efficiently handled provider enrollment and contracting will provide you with an upward revenue profit.
  7. Expand resources available to your practice or billing company: Leverage your personnel based on their strengths and your core competencies.
  8. Focus on your client’s revenue: Don’t get buried in paperwork and the process of enrollment. The new health system reform law is expected to reduce the number of uninsured Americans by 32 million people meaning additional provider enrollment work!!
  9. Gain access to established systems and tools: Credentialing/Provider Enrollment experts will help you get things done the right way and at the right time using the right people.  The most advanced systems and tools will ensure successful enrollment.

So, the next time you have a staff change, an overflow of work you can’t manage alone, the need for a subject matter expert, see an increase in denials or simply need to reduce your costs, consider contacting a credentialing services provider for assistance.

And, if you want credentialing services to remain under your company umbrella as a service you are seen to provide to your clients consider discussing a private label arrangement with the credentialing provider.


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Cynthia Young is the former CEO of STAT MedCare, LLC. STAT is a U.S.-based, national provider of credentialing, payor enrollment, rate negotiation, and other credentialing relat