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What are Credentialing Issues and Resolution?
Credentialing. It could be seen as the necessary evil for any healthcare organization, but particularly
medical practices. You can’t treat patients without proper credentialing in place, but it’s time
consuming, there are ongoing regulations to keep up with, and costly legal implications can be
associated if credentialing lapses. Here’s a glimpse into some of these issues and a resolution.
While it’s imperative that each and every physician is properly vetted and credentialed prior to
practicing for numerous reasons, the tedium that goes into the process can steal valuable time away
from patient care, scheduling and billing – also tasks incredibly important to overall business operations.
Compound all of this with the explosion of credentialing requirements and paperwork, staff can take up
to 3-5 hours each day on credentialing.
Today’s healthcare industry offers numerous challenges that lend to strapped staff time. Requirements
for hospitals and healthcare organizations continue to grow with Meaningful Use and HIPAA. As of
January 2013, only credentialed medical assistants have been permitted to enter medication, radiology,
and laboratory orders into the EHR to count toward meeting the Meaningful Use thresholds under the
Medicare and Medicaid EHR Incentive programs.
With the growing complications and tediousness of credentialing, the risk of error exists, and the
ramifications of incorrect or insufficient credentialing can cost practices and hospitals dearly. Payer
processes can be slowed, patient-risk is increased and organizations can pay hefty fines in malpractice
situations if proper paperwork is not produced.
A resolution? To best manage this oftentimes complicated task of physician credentialing, practices and
hospitals can look to vendors well-versed in the space that can securely manage the process for
credentialing and re-credentialing. Vendors should have the ability to manage profiles and documents
for physicians, help monitor for expiring credentials and have a dedicated, knowledgeable staff to
answer any questions about the process in general. Save time, save money, save the legal headaches.

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What are Credentialing Issues and Resolutions?

  • 1. What are Credentialing Issues and Resolution? Credentialing. It could be seen as the necessary evil for any healthcare organization, but particularly medical practices. You can’t treat patients without proper credentialing in place, but it’s time consuming, there are ongoing regulations to keep up with, and costly legal implications can be associated if credentialing lapses. Here’s a glimpse into some of these issues and a resolution. While it’s imperative that each and every physician is properly vetted and credentialed prior to practicing for numerous reasons, the tedium that goes into the process can steal valuable time away from patient care, scheduling and billing – also tasks incredibly important to overall business operations. Compound all of this with the explosion of credentialing requirements and paperwork, staff can take up to 3-5 hours each day on credentialing. Today’s healthcare industry offers numerous challenges that lend to strapped staff time. Requirements for hospitals and healthcare organizations continue to grow with Meaningful Use and HIPAA. As of January 2013, only credentialed medical assistants have been permitted to enter medication, radiology, and laboratory orders into the EHR to count toward meeting the Meaningful Use thresholds under the Medicare and Medicaid EHR Incentive programs. With the growing complications and tediousness of credentialing, the risk of error exists, and the ramifications of incorrect or insufficient credentialing can cost practices and hospitals dearly. Payer processes can be slowed, patient-risk is increased and organizations can pay hefty fines in malpractice situations if proper paperwork is not produced. A resolution? To best manage this oftentimes complicated task of physician credentialing, practices and hospitals can look to vendors well-versed in the space that can securely manage the process for credentialing and re-credentialing. Vendors should have the ability to manage profiles and documents for physicians, help monitor for expiring credentials and have a dedicated, knowledgeable staff to answer any questions about the process in general. Save time, save money, save the legal headaches.