If you own a healthcare facility, then starting it out must have been a roller-coaster journey. You might have worked hard to meet industry standards and policies to be able to provide your services. One such thing you also need to run your facility is medical billing credentialing services. These are the services that enable you to verify every aspect of your healthcare operations so that you can develop trust in your patients.
But before opening your hospital or clinic, you must go through a credentialing process. If you know nothing about it, then hiring a company is beneficial here. So here we have mentioned the entire credentialing process, its importance, and the top medical billing credentialing services you can hire to save effort and waste money.
What Is Medical Billing Credentialing?
As a healthcare facility owner, your goal is to provide quality care. This is only possible when you know your doctors and staff are qualified, your medicines are pure and your supplies are free from any sort of germs and bacteria.
So credentialing is the process that keeps an eye on these aspects. It makes sure your hired staff is able to provide the best care to the patients and that your supplies and medicines are of the best quality to be used during treatments.
Any oversight in your health services may lead to patient health damage. Medical billing credentialing services give you a ticket to keep providing your services and pull you under the safety umbrella that satisfies patients and healthcare laws as well.
Common Questions About Credentialing
You might not understand the entire credentialing process in one go. Don’t worry, many do not. Here we have collected the most common questions about this verification of the healthcare industry that will clear most of your confusion.
How Does The Credentialing Process Impact The Revenue Cycle?
Since you show credibility in providing quality healthcare services, insurance companies allow you to bill their patients. This way you can attract insured patients, which will bring more revenue.
Is Medical Billing Credentialing A One-Time Process Or On Going?
Imagine buying bread from a bakery, but later you realize it has expired. You won’t eat it, right? Similarly, credentialing has an expiry date too and if you don’t renew the process, no one will trust your services and thus you will generate less revenue than usual.
How Long Does The Process Usually Take?
In general, it may take a few weeks to several months for your facility to be allowed to provide your services. However, the process duration may vary depending on the documentation and review stage.
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Who Is Involved In The Credentialing Process?
Typically 3 parties are involved in credentialing, healthcare providers, insurance companies, and medical billing credentialing services agencies. Their involvement ensures the authenticity of the process and marks the procedure as complete.
Can You Perform In-House Credentialing Or Outsourcing Is The Best Option?
You can go for in-house credentialing. But if we advise, hiring an external company may handle the process better. They know what documents are required to show your credibility and maximize your chances of approval. So relying on them is a good idea if you want to approve your request in a single go.
Are There Different Credentialing Requirements For Different Specialties?
Yes, every specific healthcare specialty has its own set of quality standards and requirements when it comes to credentialing. Based on what services you provide, you must be aware of the relevant regulations so that you can comply with these terms.
Consequences Of Neglecting Credentialing
Where you have learned all about credentialing and its basics, there are some risks as well that you will confront if you don’t go through this crucial stage. Here are the following consequences you surely wouldn’t want to face as a new or even experienced healthcare facility.
Compromised Patient Safety
Set everything aside and just think about your patients’ lives. Unqualified staff like doctors and nurses treat patients the way they want or in simple words, the wrong way. Due to a lack of screening, no one is going to ask about their credentials and they continue experimenting on patients. Such a critical health issue. This mismanagement may put a patient’s life in danger. If unfortunately, any mishap happens, you will be responsible and answerable to their family and legal parties as well.
Mistrust
When patients know you didn’t fulfill the quality standards of the healthcare industry, why would they risk their lives? This makes them run away from your hospital and prefer a facility that is trusted and has shown compliance to industry standards in all aspects.
License Cancellation
If you keep providing your services without verifying your facility, then your hospital is at great threat. Government and legal agencies can visit anytime and seal your facility due to non-compliance with industry regulations. This situation can worsen when they cancel your license and you are not able to run your facility for a specific deadline or in worst case scenarios, for the lifetime.
Not only this, but you can also get stuck in a case and face severe legal consequences. This compliance is much more serious than you have ever thought it would be.
Reputation
These constant legal happenings and run away of your patients will show your healthcare facility as a no-go area. This will damage your built reputation and result in loss of patients and, eventually revenue.
Top Providers Of Medical Billing Credentialing Services
Now let’s move to the main subject, and that is which medical billing credentialing services to hire. There are a number of companies providing their services, but let us tell you the top ones among them along with their basic information. This will make your decision-making process quicker.
Medical Billers and Coders (MBC)
Experience: 20 years
MBC is a top supplier of medical billing credentialing services, giving healthcare practitioners all-inclusive solutions. They have a group of professionals who can assist you with any part of the credentialing procedure, from the first application to continuing upkeep.
CureMD
Experience: 14 Years
CureMD offers complete credentialing services to assist healthcare providers in streamlining the procedure. They offer a centralized procedure and skilled professionals who can assist you in obtaining credentials from all of the main insurance providers.
Billing Advantage
Experience: 20+ Years
To assist healthcare providers in becoming in-network with insurance companies, Billing Advantage provides credentialing services. They can manage all of the paperwork for you and assist you in identifying which insurance providers are most crucial to your business.
Right Medical Billing
Experience: 15+ years
For all of your needs related to medical billing credentialing services, Right Medical Billing is your one-stop shop. They can assist you with initial credentialing as well as ongoing maintenance.
BellMedEx
Experience: 10+ years
BellMedEx is an expert in assisting healthcare providers in obtaining accreditation from all major insurance providers. They have a group of professionals who can guide you through the difficult credentialing procedure and expedite the process.
Stay Credible
Now that you know the advantages and consequences of medical billing credentialing services, it is your responsibility to take a step now and verify your services. If you have just started out then this is more crucial for you to show your credibility.
Also, since it is an ongoing process you must remember its expiry date and renew the contract. Any mistake may lead to big consequences for both you and your patients. So prevent these issues early on to keep providing your healthcare services without worries.