Your goals are quality outcomes and patient safety, but to achieve them you must contend with the complex universe of credentialing all medical, non-medical, clinical staff, and occupational visitors. With decreasing reimbursement, soaring costs, the implementation of the Affordable Care Act (ACA), and the creation of accountable care organizations (ACOs), the perfect storm has been created. To receive timely payment for your services, you must find your way through this compliance maze which includes working with various payers such as Medicaid and Medicare. The collection of data, monitoring, credentialing, and verification to receive reimbursement is the necessary evil of maintaining healthcare compliance. How do you stay the course and keep focused on what matters most, your patients?

Outsourcing the frustrating task of managing the compliance lifecycle makes financial sense for medical practices and facilities. Let’s review why outsourcing your credentialing and verification keeps your business healthy:

  1. Reduces Labor Costs: Seismic changes in healthcare payment models are forcing providers to find new ways to increase productivity and revenue while cutting costs. Care providers are experiencing a sustained increase in their daily workload. Most likely, the staff charged with handling collection, tracking, verification and credentialing has other jobs to do. Timely verification is often pushed aside to deal with more urgent matters. This reprioritization can create problems affecting costs, efficiency, and quality of care. Often, your staff is forced to rush through credentialing or must work longer shifts or put in weekends to keep up. For non-exempt employees, this results in overtime; for exempt employees, this causes frustration and anxiety. Privacy and security issues aside, taking this work home decreases overall job satisfaction and encroaches on your staff’s quality of life. Outsourcing credentialing and verification solves all of these concerns.
  1. Increases Efficiency: The growth of M&A activity and physician alignment strategies has caused an unprecedented increase in physician onboarding with physicians being cross-credentialed and enrolled across multiple healthcare facilities. Additionally, a physician shortage has necessitated an increase in the hiring of allied health providers. As mentioned earlier, it’s likely the person who handles enrollment has other responsibilities too. Each job competes for that person’s time which results in a lot of task switching. Transitioning between projects introduces delays and inefficiencies which can lead to errors. By outsourcing, multiple tasks are removed from that person’s plate, increasing his or her overall efficiency in the remaining areas. Even if a person’s sole job is the accuracy of credentialing, office distractions and secondary issues continually threaten to lessen efficiency. Outsourcing your medical and non-medical credentialing process is the answer.
  1. Eliminates Risk of Errors: What happens when the credentialing process is partially complete and the person who initiated the effort leaves? Is there adequate documentation about what has been gathered and submitted? Can someone else step in and take over? In a worse-case scenario, the replacement person may need to start the credentialing process completely over. Turnover generates additional labor costs and introduces even more delays. Outsourcing the process eliminates all of these risks.

By outsourcing the critical functions of credentialing and verification, you gain a tangible means of reducing labor costs, increasing overall efficiency, and eliminating the errors caused by turnover. Compliance and credentialing are necessary to remain viable as a healthcare organization, but it does not need to take your team’s focus off of your core competency.

Outsourcing credentialing to IntelliCentrics, the premier provider of managed services dedicated to the compliance lifecycle, will enable you to meet your facility’s operational and financial goals. We take the frustration out of the process, and you and your team can concentrate on what you are meant to do—delivering quality patient care and keeping our communities healthy. We all play a role.

5 Reasons Why Now is the Time to Outsource Medical Staff Credentialing

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