It is a well-known fact that many providers are attempting to reduce their Payer enrollment issues. Having major advantages of proving the authenticity of the providers and making networks to providers, they must be completed as promptly as possible. It is one such process that might burn daylight if done wrong. So, focusing to reduce the pain points in the credentialing process is critical for successful Payer enrollment.
Two factors that must be kept in mind to make your work streamlined are:
One problem that needs to be addressed is using expired documents for your medical credentialing application. These documents will make your application move to denial due to the outdated information in the documents. Next to that, mistake made by almost all providers is reducing two-way communication between them and the Payer.
Here are some common repercussions that might arise if you are not looking on these issues.
Why communications are detained?
It must have been so common in your childhood that you must have been insisted to ask questions. But why is it insisted on so frequently? This is primarily due to the fact that your questions and interactions with your teachers will provide clear clarifications of what you have learned. Similarly, it is critical to maintain contact with the Payer in order to clear their doubts.
This is the first issue to be addressed which is having proper communication. One common misconception among providers is that once your medical credentialing application is submitted, your part of the commitment is complete. But that is not the case; your application process is just beginning. Because of this misunderstanding, providers are putting a halt to their conversations with their suppliers.
Understand your role after submitting application
It is obvious that by submitting your application for Payer enrollment, you are initiating a lengthy process. Another point to note is that the information and verification are all about the provider’s personal information. This clearly states your role, which is to clarify your personal information to the payers.
With immense legal data’s and verifications involved they might get affirmation from your side about the same. This can be with a phone call or a mail, so getting in touch with the authorities will make the process quite easy for you.
Get in touch immediately with the officials
So, after all the only solution to this liability is having end-to-end communication. After submitting your application, you can immediately get in touch with the officials and ask them about the further details and documents that might be needed to your enrollment.
This will bring an automatic connect between your Payer and provider thereby making payers to clarify their doubts then and there.
Don’t hide information
There is always this saying to not hide anything from doctors. Same applies to doctors as well when it comes to healthcare credentialing services. They must not hide any information from the payers. If you’re having a pending document that needs to be sent or if you are waiting for a document that you have applied for renewal, do give prior information of the same to them. Don’t assume that it will not affect your enrollment process.
There is this high chance that your application being rejected just because it was missing during their reviewing. It’s common to happen you must realize these supporting documents will what prove your authenticity to them which they are not going to compromise.
What happens with the submission of lapsed documents?
Next, critical area of focus is addressing the usage of expired documents in your Payer enrollment application. Legal documents are crucial for getting approvals in your Payer enrollment. This will make delay in your enrollment process. As it proves authenticity related to providers, submission of expired documents also rejects you. Know about the documents checklist that needs utmost care and make sure that they are up-to-date.
Eminent importance of medical license
A medical license for your practice service is a foremost document that you must have in your hand whenever asked. Whatever your experience is or whoever you are, the license will only give you proof that you are an approved physician. Also, be aware whether your license is valid in the state you’re practicing. Doing practice with an expired license can make you face legal actions and might lead to risk factors in your career.
One common blunder done by many practices is submitting a legalized document or your license that is about to expire. When being reviewed, it might be already in the place of the expired state this will cause rejections even though it was valid at the time of your submission of the application.
Authorizes you to prescribe controlled substances
If you are providing advanced clinical treatments or you are a physician, you must possess a DEA registration that allows you to prescribe controlled substances to patients. Only after being approved by drug enforcement, you can start prescribing them. But these are not given lifetime approval. So, do follow the renewals appropriately.
Being as an important criteria in your healthcare credentialing process failing to take note of this document will make your application pass with rejected lists.
Know the state rules of CEUs
It is well-known fact that each state will differ with the regulations that are carefully laid in their healthcare RCM services. So always know what your state requires. There is this need for continuing education that is mandatory for providers to continue with their practice.
One effect is that when you fail to follow the CEU rules corresponding to your state there will be sanctions on you if you fail to do so. These make a black mark in your service that might leave you to face legal consequences.
Renew your malpractice insurance on time
Never give opportunities for the payers to come up with mistakes. Think forwardly, expect what is expected, this will help you in minimizing mistakes. Many face the issue of submitting a correct document but getting rejected as it got expired during the reviewing time.
Malpractice insurance is important for providers. It requires renewals very often. So, before submitting verify the expiry date. One way to ensure appropriate submission is by applying with a document that has maximum time for its expiry. This reduces the chances of getting rejected.
Have an updated CAQH profile
As a provider, with the various fields and information updated for your enrollment application. You should also be aware of CAQH (Council for Affordable Quality Healthcare), which serves as a provider data repository for payers. As it is required by the majority of payers to conduct checks on a variety of healthcare RCM services that involve provider verification, which includes for healthcare credentialing services and other processes.
So, updating your personal and work details that are relevant to your actual status is critical for enrollment approval from payers.
This might be so common or simple to hear but these are the only tactics that can be applied to help you come out of the burdens. To handle with different legal information and obtain quicker Payer enrollment, it’s so important to be correct and accurate.
If you are facing complexities try partnering with a third-party organization for quick approvals of your medical credentialing .Get in touch with Practolytics to make your enrollment successful. We act as a one stop solution for all your healthcare RCM services.