Expanding your practice and bringing in new providers can be an interesting prospect. But the complexities in the payor enrollment process makes it equally challenging. To bring in financial and operational stability for your healthcare practice, it is important to make sure that your payor enrollment process is well-defined and seamless. To achieve this, it is necessary to first identify and eliminate the major problems in the payor enrollment process.
Following are the most common healthcare payor enrollment challenges that providers need to overcome in order to establish and maintain a steady revenue stream for your practice.
Not Disclosing Complete Details
A common mistake that most providers make during the payor enrollment process is not submitting all the necessary information. Details related to work history, hospital privileges, ownership information, or even signatures are some of the most common things that providers forget to mention during their enrollment process.
Such information gaps, even though quite trivial, are enough to bring your enrollment process to a halt. Not disclosing negative information such as malpractice cases can also be a bad decision as it will come up in the enrollment process and put your application in jeopardy.
Lack of Timely Follow Up
Filling up the credentialing and provider enrollment applications accurately and submitting them with all necessary documents is certainly a tedious task. But the real challenge begins after you submit your application. Insurance networks have a huge number of applications to deal with. So it is possible for your application to get lost or incorrectly processed.
Follow-ups are imperative to make sure you get enrolled properly and quickly. Regular phone calls or emails can make sure that your application has been received by the network and can help you in finding out the exact status of your application. Hence, providers need to make follow-up a part of their routine and continue with it until their application is approved.
Re-attestation or Updation Failures
All healthcare providers are bound to always keep their Council for Affordable Quality Healthcare (CAQH) profiles updated with the latest and most accurate information. These profiles need to be re-attested and updated to review and authorize data once every four months. This makes sure you keep getting paid for the services you offer.
It is important for the administrative staff to be proactive when it comes to uploading the updated insurance, license, and other documents to the CAQH profile regularly. Avoiding delays and errors in this process prevents disruptions and ensures you get paid correctly for your healthcare services.
Investing Too Much Time and Money
Medical credentialing and payor enrollment is an arduous and extremely complicated process. Without the assistance of expert professionals, this procedure can take up a lot of your time and can also lead to costly mistakes. The expenses associated with an in-house team are also much higher than that of an outsourced payor enrollment provider.
Both small and large organizations can benefit from outsourcing their payor enrollment services. By outsourcing, you can not only cut down a lot of unnecessary expenses but also save yourself the hassle of spending hours on follow-ups. This can also enable you to focus on your core activities without any distractions.
Partner with STAT MedCare – an industry-leading credentialing and provider enrollment company to complete your entire enrollment process without any errors or delays. We can help you refine and optimize your payor enrollment processes to drive high returns for your practice. Contact us to know more about our credentialing, payor provider enrollment, licensing, and other services.