Credentialing Tools for Success: Checklists and Software Solutions

Your provider cash flow will come to a screeching halt unless you secure on-time insurance enrollment and hospital privileges. But with so many steps and forms to keep up-to-date, avoiding an accidental lapse in credentials can be really easy.

With the right tools, you can stay on top of the process and your reimbursements flowing.

Credentialing Tools to Track Moving Parts: Software Solutions

Organizing personal information, training and education, licensing, employment history, certifications, and more, for credentialing can quickly become a logistical nightmare. And every provider’s background is different, so aside from the multitude of data to keep track of, there are a host of changing variables that affect the process.

There are several software solutions available ranging from complete credentialing systems to simple software programs that you can use to get the job done. Some of the credentialing tools that will help you organize your credentialing data include:

Credentialing software. Credentialing software can help you track and update provider information and notify you when a deadline is looming or it’s time to renew. You can also find cloud-based management systems for both credentialing and compliance documentation. When investigating a credentialing software solution, do your research to make sure the benefit is worth your financial investment.
Microsoft Excel is an excellent spreadsheet application that you can use for credentialing tools to track your physician data. With a spreadsheet, you can easily sort and filter the data to analyze it in different ways, track provider credentialing status, and highlight important dates and completion status. You can share a spreadsheet on a server or keep it on your local machine. The cost risk is low because many people already run Microsoft Office.
Checklists and calendar reminders. You can create a checklist for your credentialing process in a simple Microsoft Word document. List the different tasks, completion date, and input any additional comments that will help you stay on track. You can also input important dates into your electronic calendar and set up alerts for reminders so you don’t miss any deadlines.

Try this free credentialing tool: If you aren’t sure where to start, download our easy-to-use Excel Sample Tracking Document. Our sample credentialing tool has multiple tabs to track provider data, deadlines, status, and other details. Plus, you can easily customize it and tailor it to suit your own needs.

Credentialing Tools to Stay Organized: Checklists

In order to get the most out of your credentialing tools, you need to plan out the details that you’ll include in your credentialing tracking system. Part of the system includes identifying all the data fields that you need to report. For example, if you use Excel, you need to know what data to enter as headings. In setting up your credentialing tool to track the data, consider these questions:

Do you want to report only data?
Do you want to track dates and where you are in your process?
Do you want to report approvals?
Do you want to report any risks/red flags?
Do you want to record when you provided data to whom (for instance, sent to HR or Billing)?
Do you want to report who is assigned the file?

The key to success is to create a system that works for your entire practice, not just one biller. Use these tips when creating your provider enrollment tracking system:

Create a system that allows you to track where the application is in the process
Signal upcoming due dates to make sure things don’t fall through the cracks
Make a versatile system that all your staff can learn and have access to
Create a system to ensure providers understand the importance of fast responses and expectations.
Provide ongoing education and awareness of the importance of provider enrollment
Make your system flexible and adaptable to anticipate problems and accommodate inevitable regulatory changes

For more plain-English, easy-to-implement credentialing and enrollment monitoring strategies, credentialing expert, Tracey Tokheim, can help. During her 60-minute online training, “Proven Tools to Improve Provider Credentialing & Enrollment Results,” Tracey will walk you through each step of a successful credentialing and enrollment management process.