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The Benefits of Medical Credentialing Services

Medical credentialing
In: Business, Health

Medical credentialing opens the gates in the healthcare world that were previously closed to medical providers. Therefore, Medical practitioners can provide care to more patients and increase their overall revenue potential. As insurance companies are liable to reimburse them via good credentialing.

While essential to access new patient audiences, the medical credentialing procedure may be lengthy and time-consuming. Understanding how medical credentialing works may help your practice streamline all of its credentialing obligations, which can speed up the process.

What does credentialing mean and how does it work?

Insurance providers used medical credentialing to analyze and verify a doctor’s or other practitioner’s qualifications. Verifying the physician’s education, training, residency, licensure, malpractice coverage, clinical judgment, and certifications all come in the remit of the medical credentialing specialist’s job description. The insurance uses data collection, source verification, and committee review, among other procedures, to ensure that the practising physician meets the medical community’s quality standard.

Credentialing and privileging are the two phases of the medical credentialing process. While answering a question, what is credentialing in healthcare?  Credentialing in healthcare is a process that certifies a physician’s competency by evaluating their education, training, licensure, and work experience, privileging is the insurance approval of a physician or medical practice to conduct certain operations based on the verification review.

Why is credentialing important for medical assistants?

The process of healthcare credentialing serves several purposes. Credentialing ensures the medical industry’s quality by ensuring that all physicians comply with the best quality of care and perform the clinical services for which they are certified.

Physicians who have relevant skills and expertise can perform particular treatments on insured patients that are permitted to practice by successful credentialing. It ensures both the patient’s safety and the medical community. Medical credentialing also ensures that medical practices get timely reimbursements and payments from third-party payers. Credentialed medical practices can increase their profits streams by increasing the number of patients who have access to them. 

Top Reasons Why Medical Credentialing is Important for Your Medical Practice

Healthcare credentialing offers several services for medical practices that want to be credentialed and privileged by an insurance company. Some important reasons are listed below.

Ensure Quality Assurance

The medical credentialing process, as previously mentioned, ensures quality in the healthcare industry. The healthcare community continuously ensures that the designed quality standards met the benefit of patients. Insurance companies prefer medical doctors and practices that have demonstrated expertise in their fields to keep costs low.

Enrich your Practice Reputation

Patients are doing more research than ever before committing to a healthcare practice or physician. It might include checking into their background or patient reviews on the internet. One of the most effective strategies to improve your online reputation is to undergo medical credentialing. Credentials suggest that your medical practice is well-established, reputable, and trustworthy to potential patients when they investigate it online.

Maintain Patient Safety

Credentialing ensures that practices and physicians have the experience and skills necessary to execute treatments on patients, which helps to protect patient safety. The procedure aims to minimize medical errors caused by inexperienced healthcare providers. Credentialing helps restore confidence between patients and medical practitioners by providing background knowledge. Patients may put their full faith in their physicians’ competence if they know they have the qualifications and merit to be their chosen providers.

Prevent Losing Revenues

Medical practices might lose thousands of dollars in revenue due to delayed or refused payments if they are not properly credentialed. Insurance companies may refuse to reimburse, medical practitioners for treatments, if they fail, to get adequate credentialing or make mistakes throughout the process. When a medical practice allows a physician, to deliver services before or during the credentialing process, the insurance payer may be able to backdate the reimbursement to cover the treatments.

Medical credentialing

Boost Your Patient Count

Physician credentialing permits medical practitioners to reach previously inaccessible patient bases by allowing them to accept health-insurance-covered treatments. Most Americans have health insurance plans (HMO, PPO, POS), with 92 percent having coverage in 2019. This enables medical practices to broaden their client base and possibly increase revenue. 

HMO; Stands for Health Maintenance Organization, and the coverage limits patients to a specific network of physicians.

PPO; Stands for Preferred Provider Organization. It allows patients to see any doctor they choose, whether inside or outside their network.

POS; A point-of-service (POS) health insurance plan offers various benefits based on whether the policyholder visits out-of-network healthcare providers. POS plans are often less expensive than other types of plans.

Provide a Competitive Edge

Medical practices must develop strategies to distinguish themselves in the competitive world of healthcare. Medical credentialing shows potential to new patients that your medical practice employs specialists with relevant expertise. Furthermore, acquiring a credential can help you recruit well-qualified physicians, who are more likely to join a credentialed practice, with a large patient base than someone who does not. The medical credentialing procedure gives your medical practice, an advantage over competitors in your industry, and allows you to keep growing.

Transform your healthcare Practice Credentialing with NeoMD

Healthcare credentialing has several advantages for medical practitioners who want to provide the best possible treatment to their patients and acquire a competitive edge. Regardless of its advantages, one should not ignore the challenges of credentialing. Your medical practice may face delays if all of the documentation isn’t handled appropriately.

You can trust that specialists will handle the entire process if you choose outside medical credentialing services. With NeoMD, your physician credentialing is processed correctly – the first time around! Our experts specialize, in custom revenue cycle management, and can handle the complex credentialing procedure, for you so you can focus on caring for your patients, and expanding your medical practice.

Turn to the NeoMD medical credentialing professional to learn more about how you may get the benefits of credentialing without the hassle! Contact our team now to learn more about how we can assist you to transform your credentialing process!

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