Why is Credentialing important for your Practice?

Provider credentialing is very important for your practice. Only when a doctor is given proper credentials by the insurance company and allowed to join their network, he/she can start receiving reimbursement for the services they provide.


Credentialing is not only important to get paid but also to deliver quality care to your patients. It is the simplest and most effective method to hire competent doctors for your practice because it lets you verify, compare and evaluate the qualification of the doctor you wish to hire.


Credentialing also helps increase efficiency and process improvement at the practice. This process allows patients to place their trust in their chosen healthcare providers. If they are assured of their healthcare professional’s merit and experience, they will keep coming back to your practice.


Is credentialing a regulatory burden?


If not done in the right manner, lack of medical credentialing can wreak havoc on your practice, cause scheduling delays and fluctuate your revenue cycle to a great extent. So practices need to take enough time to complete the credentialing process.


If your practice fails to fully verify a doctor’s credentials before hiring him/her, you will be running the risk of incurring serious financial and legal consequences not only for you but also for the doctor.


Patience is very important in the credentialing process because it can take anywhere from three to four months. There is a lot of paperwork involved along with submission of documents and getting in touch with insurance credentialing departments. Since the entire process seems undesirable and complex, many practices choose to hire a third party for handling the procedure.


How can outsourcing help in credentialing?


If credentialing is overwhelming for your practice, then outsourcing will help you manage this process with the least amount of stress and with accuracy.

A reliable medical billing company can help your practice in several different ways.


From handling the  process of filing applications with insurance companies and getting approval for work comp carriers to performing credentialing with hospitals and for CMS, the company will handle all the hassles of credentialing, freeing up your time for patient care.


Also, you need to remember that this is an ongoing process because just a one-time verification and evaluation check won’t be sufficient to fulfil the expectations of your patients. So make sure you let an expert team handle this task.

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