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3 Provider Enrollment Barriers and How to Overcome Them

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3 Provider Enrollment Barriers and How to Overcome Them

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Provider enrollment and credentialing

One of the simplest and fastest ways to keep reimbursement flowing at your practice is to ensure your provider enrollment and credentialing processes never face any hiccups. After all, if you don’t get your providers enrolled and credentialed swiftly, they could be terminated from payer networks and dropped from hospital admitting rolls. Plus, you’ll be paying providers their salaries even though they won’t be able to treat patients.

To keep your pay flowing, avoid the most common barriers to provider enrollment and credentialing success by following a few best practices.

1. You’re Overwhelmed by All the Moving Parts

One of the biggest barriers to success when it comes to provider enrollment and credentialing is the fact that the process is incredibly complicated, featuring a variety of moving pieces. If you just let one feature fall through the cracks, you could sink your odds of success.

To overcome this obstacle, your best bet is to use all of the tools at your disposal and invest in new programs if you need them. You can find software programs or spreadsheet options that will help you monitor and track the enrollment and credentialing tasks, or you can use an old-fashioned notebook where you list every feature and check them off as you go.

Some practices find success by setting calendar reminders to ensure that each step of the process is being tackled. If your calendar reminds you that it’s time to move on to step two and you notice that step one hasn’t been finalized by your payer, you can follow up with them and find out what the holdup is before you fall too far behind.

2. The Provider Isn’t Communicative

If you’re trying to credential a provider, it’s imperative that you have all of the most relevant information about that person, including:

  • Licensure
  • DEA
  • Education
  • Training
  • Health status
  • Professional experience and performance
  • Professional liability insurance coverage

If you don’t have these details, you aren’t likely to be successful in completing the provider enrollment process. Therefore, you should get all of the information up front from the provider and create a two-way communication flow so you’ll have no problem going back to them if you’re missing anything along the way.

3. There’s a Lack of Support at Your Practice About Credentialing

You may hit provider enrollment and credentialing roadblocks along the way if your colleagues don’t know how important the process is, or don’t understand the steps required, and therefore don’t support your efforts. One key to a smooth enrollment is getting help from your colleagues, who can share information about new providers, recertifications, hospital admitting privileges and more. Without teamwork, you’ll experience headaches along the way.

That’s why it’s essential that everyone in your practice is educated about the importance of provider enrollment and credentialing, and that there isn’t just one staff member who’s aware of the process. Even if you’re the enrollment point person, you should share the process and documents with colleagues who can help follow up on applications when you’re on vacation or out sick. It’s also important to mentor new people to help them be successful in this process. The only way to get better participation during the process is to share your knowledge along the way.

Ensure that your provider credentialing/enrollment processes go smoothly with tips from credentialing expert Tracey Tokheim. During her 90-minute online training event, “Credentialing/Enrollment 101, Get Approved/Paid Faster & Easier,” Tracey will walk you through every step of the enrollment process so you’ll sail through with flying colors. Sign up today!

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