From medical practitioners to patients and governmental agencies, everyone can benefit from proper credentialing. With an efficient workflow, medical companies can mitigate related risks, ensuring that the users get the best possible protection while simultaneously preventing hefty fines.
Due to the importance of credentialing, healthcare businesses often hire external providers to help them with the process. Partnering up with renowned CVOs (credentialing verification organizations) can reduce your micromanagement, streamline day-to-day procedures and onboarding, and allow you to focus on patient care.
In this article, we’ll explain the process of credentialing outsourcing and, specifically, how it affects certain business risks.
Importance of credentialing for insurance companies
As mentioned, credentialing is important for everyone involved, and that includes insurance companies and health plan providers. Among other things, a well-planned credentialing process is vital for cutting costs for patients and providing them with better assistance.
Unfortunately, many healthcare providers don’t pay enough attention to this procedure. Not only can this expose your business to fines, but it can also reduce the team’s performance. This is how CVOs can help insurance companies:
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Compliance with the current regulation
For many companies, credentialing is, first and foremost, a way to avoid government sanctions. By having a meticulous process, health plan providers can show these agencies that they’re committed to excellence. Generally speaking, companies that do everything by the book are under less pressure and enjoy a much better reputation among patients and government organizations.
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Ensuring high competence
During a standard verification process, a team or person in charge goes through practitioners’ educational background, past training and experience, certificates, licenses, and active sanctions and bans.
By going through all these documents, healthcare organizations can mitigate any risk associated with hiring less-than-stellar performers. Besides adhering to rigorous policies, a comprehensive credentialing process allows you to snatch the best talent on the job market, which would, in turn, ensure the highest patient satisfaction.
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Improving satisfaction rates
The medical legislation wasn’t created on a whim. It is based on extensive empirical data that would ensure the highest protection for patients. That being said, as long as you abide by these laws, your medical practice can provide excellent service, thus boosting its reputation.
Related to that, adhering to current laws can reduce the risk of medical errors and malpractice, both of which are big reasons behind users being dissatisfied. CVOs, in particular, are well aware of the latest regulatory changes and can ensure that you’re always on top of things.
Biggest credentialing risks and challenges
Credentialing is a highly streamlined, granular process that follows a strict procedure. There are numerous steps that your company has to perform during onboarding, with small mistakes potentially getting you in trouble. Here are some of the biggest risks and challenges medical businesses face and how CVOs can mitigate some of them:
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Time-consuming
Perhaps the biggest issue with credentialing is that it takes so much time. This is especially troublesome for small practices that don’t have enough time to perform verification themselves. Although hiring CVOs might be expensive for these companies, it still beats dealing with the complex credentialing procedure.
Furthermore, unlike many healthcare organizations, CVOs have a much better understanding of the process. With this knowledge, the external providers can create a simple workflow that would expedite day-to-day operations. On top of that, CVOs utilize the latest software that would prevent potential errors and save time.
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Lack of knowledge
Many medical organizations don’t have the necessary know-how to perform credential verifications in an efficient manner. What’s worse is that many healthcare providers believe that the procedure is easy enough and doesn’t warrant outside assistance. This way of thinking not only leads to costly errors but also affects the company’s productivity.
While the issue can be mitigated through the creation of specialized, in-house time, creating such a team would take lots of resources. Furthermore, there are always growing pains that can result in extra costs. So, to avoid all these challenges, many healthcare organizations hire veteran CVOs to help them out.
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Lower performance
The onboarding should be as quick as possible, ensuring that you have enough specialists on your payroll. Small delays can be disastrous as they can significantly affect a company’s performance. What’s worse is that there are also many situations where you will be understaffed and will have to take financial losses because you can’t treat incoming patients.
One of the major yet underrated benefits of CVOs is that they can track the best talent on the market. By analyzing numerous applicants, they can find the best-suited professionals for your hospital or clinic.
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High expenses
While many companies believe that hiring a CVO will boost their overall operative expenses, it’s actually quite the opposite. Due to the simplified process, you’re actually saving money when you partner up with these providers. However, there’s more.
After signing a contract with practitioners, you’re obliged to pay their salaries. Nevertheless, they still can’t work for you until credentialing is complete. In other words, the longer the process takes, the more money you’ll waste, something that can be mitigated by working with CVO.
Simplifying credentialing process
The best way CVO can mitigate your credentialing risks is by simplifying the procedure. Here’s how these providers can help you out:
- Streamline the application process
- Reduce errors through advanced software
- Easily verify documents
- Use know-how to address potential bottlenecks
As previously mentioned, these experts know their stuff. They don’t waste time on unnecessary procedures and have, over time, created the optimal workflow for credentialing. In other words, no matter how much you try to simplify the process, there will always be someone who can do it better.
It’s also worth mentioning that hiring CVOs can significantly reduce micromanagement. Instead of hassling with the arduous administrative process, your staff can focus on the thing it does best – providing excellent care to the patients.
