The payor enrollment process can be a back-breaking exercise for healthcare providers. A lot of time and effort goes into filling up a tall stack of forms. Getting medical practitioners enrolled in the insurance network is important so you can claim reimbursements for their services. There are various ways in which healthcare providers can expedite this process and save a lot of their precious time and effort.
Look at the top 4 strategies to help you establish and maintain an efficient payor enrollment process.
Maintain an Organized Payor Enrollment Workflow
Payor enrollment comes with a huge set of complex prerequisites. These requirements may also differ from place to place, making it even more difficult for healthcare providers. To make the process smooth and easy, you should start the payor enrollment process immediately when you onboard a new provider. This will avoid unwanted delays, and the applications will move ahead faster. Creating a checklist of all necessary forms and documents and digitalizing payor enrollment, can help practitioners have a clear idea of the requirements, thereby enabling them to get enrolled faster.
Select Most Suitable Health Insurance Plans and Networks
Choosing the right insurance network can be quite confusing. Several factors have to be assessed before making a decision. This is an important step in the payor enrollment process as it influences the reimbursements. Eventually, healthcare provider organizations receive for the medical services they provide. Failing to choose the apt insurance network can not only affect your reimbursement rates but also have an effect on your practice’s overall workflow. Enrolling practitioners into the right insurance networks ensures your practice’s revenue stream flows seamlessly.
Manage and Meet Special Enrollment Requirements
Regarding the healthcare credentialing and payor enrollment process, the rules and regulations may vary from state to state. For instance, the required licenses, submission methods, or backdating restrictions may differ for different states. Practitioners belonging to another state may require additional documents along with the basic forms filled out by everyone. Not looking after these things can lead to delays in the payor enrollment’s process and may even affect the collections of the healthcare provider organization.
Submit Error-free Applications and Follow Up Regularly
The application for payor enrollment generally requires information about identification, educational qualifications, licenses, certifications, affiliations, references, and work history. Any small error while entering this information can become an expensive mistake for the healthcare provider. Apart from filling out accurate information, it is also necessary to regularly follow up with the insurance providers to check the status of applications. The best way to do this is to be proactive and take quick corrective actions when the application is denied.
Maintaining an efficient payor enrollment workflow is vital to safeguarding and raising the revenue of your healthcare practice. Without a well-rounded payor enrollment’s program, your practice can fail to streamline the enrollments of practitioners into insurance networks. STAT MedCare can eliminate these concerns by providing top-notch payor enrollment and credentialing services to healthcare providers. Get in touch with us to learn more about our service offerings.