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3 Provider Onboarding Enrollment Mistakes and How to Fix Them

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3 Provider Onboarding Enrollment Mistakes and How to Fix Them

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Provider credentialing

Onboarding a new provider takes a lot of legwork, from recruiting to contract negotiation and beyond. So it’s common to put a tremendous amount of effort into finalizing an employment agreement. What may fall through the cracks at that point, however, is a quick provider credentialing and enrollment process that could allow your practice to start bringing in reimbursement faster.

Check out three common mistakes that many practices make during onboarding, along with strategies that can help you smooth the provider credentialing process so you can bring in cash.

1. Leaders Make Decisions in a Vacuum

If the practice managers, medical directors or other leaders make decisions based on their needs without considering the needs of other practice team members, it can create a ripple effect throughout the office.

For example: Suppose the practice’s medical director is eager to get a new allergist on staff, and extends a lucrative contract to a prospective provider. The new allergist signs the paperwork, which offers him a specific salary and bonus structure. The practice manager sees the contract afterward and alerts the medical director that the new allergist’s pay almost exceeds what he will be able to collect in reimbursement. This means that unless the new allergist can go through provider credentialing swiftly and start collecting from payers on his first day, the practice will end up losing money on the hire. This issue could have been prevented if the practice manager and medical director had discussed numbers before an offer was extended.

2. Inefficient Interdepartmental Relationships

Communications between the departments at your practice should occur easily and frequently, but if the interdepartmental relationship is inefficient, you could make huge mistakes during onboarding.

For example: Your practice hires a new provider, and the HR department thinks that the billing department is going to collect the details necessary for provider credentialing. The billing department, however, expects the HR director to gather that information and pass it on to them. By the time the billing team realizes no one has gotten the details necessary for enrollment, it’s too late to process the provider credentialing paperwork necessary for the provider to see patients as soon as she starts. This issue could have been avoided if the practice had a checklist in place that everyone had to follow, which outlined who should gather each kernel of information and at which point they should have it in place.

3. Providers Have No Skin the Game

When providers join your practice, it’s important for them to be incentivized to complete the provider credentialing and enrollment process as quickly as possible. If they don’t have skin in the game, they may not see the urgency to this task.

For example: You hire a new orthopedic surgeon and the contract lays out working hours, salary and bonus information, but not any other information. In this case, the provider gets the agreed-upon salary and bonus whether or not they complete provider credentialing and enrollment quickly. This issue could be prevented if the practice included a stipulation in the contract noting that the provider’s salary would be reduced if they didn’t provide the necessary information required for swift credentialing.

How to Fix These Issues

Create a staff meeting that takes place before the recruitment process begins, which includes people from HR, billing, provider credentialing, clinical staff and recruitment. Ensure that everyone is able to present their needs so they can ensure that the contract is created in a way that maximum reimbursement comes in for the provider, and that enrollment happens quickly.

Make sure that during this process, the team has an accurate calculation of how much a pay provider is costing the practice. This includes not just the salary, but also the payroll taxes you pay, any bonuses, a pager or cell phone stipend, their health care benefits and everything else it costs your practice to employ that provider.

Then calculate how much revenue you’ll have to bring in to cover those costs. If you’re not doing this, you have no idea whether you’re losing money on a provider — and no provider should ever be a cost center for a practice. Once you have that information, you can create the provider’s contract accordingly.

Your next step is to create an onboarding checklist that the provider completes on the same day that they sign their employment contract. It should include every detail you need to complete provider credentialing immediately. If the provider does not complete that documentation quickly enough to bring in pay for them on day one, there should be an impact to their salary, and those details should also be included in the employment contract.

Discover more tips on getting your providers credentialed quickly so you can collect reimbursement faster from expert David J. Zetter, PHR, SHRM-CP, CHCC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP. During his latest online training, Speed Up Credentialing & Reimbursement for New Providers, David will share the strategies that can help you bring in cash quickly. Register today!

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