Credentialing specialists understand details. They have no shortage of data to maintain, from verifying medical staff credentials to ensuring that service providers, healthcare facilities, and insurance companies comply with federal and state credentialing regulations for medical professionals.
As if all of that isn’t enough, it also falls to them to process new applications for physician clinical privileges as well as to ensure that all healthcare providers renew or update their certifications and licensures on time. It’s a big job, to say the least.
Credentialing Mistakes Can Lead to Huge Problems
At a large insurance company representing hundreds of thousands of doctors, staying on top of the renewal processes for each of them can be especially daunting. Because of the limited time period for credential completion and approval and because each state has different rules, requirements, and deadlines for documentation, there are a lot of details to juggle, especially if the company insures doctors across multiple states.
To avoid fines, credentialing specialists must gather and submit the required documentation in time to meet stringent compliance timelines. When managing that process for thousands of doctors with overlapping renewal deadlines the task can be overwhelming. Even with an entire team or department dedicated to credentialing, one word comes to mind: headache.
Adding another layer of confusion is that fact that most organizations still use paper-based credentialing processes. Not only are paper documents messier to store and manage, but they’re also not very secure. Because the confidentiality of documents containing provider information is carefully regulated – similar to the way HIPAA protects patients’ protected health information – mismanaging them can result in fines.
Document mismanagement can even turn from expensive to deadly if a credentialing error is made, allowing a medical provider to perform services they are not qualified to perform. A mistake like this could hurt a patient and quickly land an organization in huge financial and ethical trouble.
Workflow Automation Software Manages the Details for You
Workflow automation software is the fix for your organization’s slow paper-based credentialing process. The software can kick off an automated renewal process based on an expiration date and notify the credentialing team that the process has begun. Then, instead of requesting and processing paper renewal documents, you can use e-forms to collect the necessary information.
If you opt for a robust software solution like FileBound Enterprise, you can also get automatic alerts when files are missing documentation, helping ensure each file is complete. Wouldn’t it be great to always be prepared for audits instead of having to scramble each year to get records in order? FileBound’s document management software is perfect for large organizations with multiple locations. Instead of scanning documents back and forth, your credentialing team will have secure access to all records from any authorized computer or mobile device.
It’s time you closed the door on risky credentialing errors. Download our free automation guide to learn more about how much money you could save by automating your credentialing process.