The True Cost of Credentialing for Billing Services Organizations

Uncovering a new provider’s credentialing statuses can be time-consuming and confusing. Here is how billing services can simplify your clients’ credentialing with the right partner.

Have you experienced staffing and workload changes due to the COVID-19 pandemic?

Are you maximizing your team’s potential?

Is your current process scalable?

These are just a few of the questions circling around billing service organization today. After a complicated year, the healthcare industry has undoubtedly been thrown for a loop. Not only have frontline workers seen unprecedented challenges; pandemic-related changes have affected all levels of healthcare, from executive leadership to front office administrators.

One of the most critical behind-the-scenes tasks falls on the aforementioned administrators. Medical billing, whether in-house or through a third party organization, helps keep an office running by controlling the business side of revenue collection. But the workload often goes beyond just sending patient statements and processing payments.

Before the bill is sent and payment information is entered by a patient, a provider needs to ensure one important aspect is in place – their medical credentials. Simply put, without the proper credentials, physicians cannot get paid. It’s been said that incomplete payer credentialing can cost a physician up to $6,600 per day. We all know that a practitioner that lacks proper credentials is at risk of losing reimbursement. Much to the chagrin of the doctor and their practice or healthcare system, gaining or maintaining the necessary credentials is not as easy as one would hope. To simplify the process, many medical practices and organizations often outsource their credentialing to a professional billing service company. But uncovering a new provider’s credentialing statuses can be time-consuming and confusing, even for devoted experts that focus on this day in and day out. If the right players aren’t in the right position, so to speak, the billing company could be losing valuable time, which could hurt their client’s bottom line and the relationship.

So it begs the questionWhat’s the true cost of credentialing?

Perhaps your staff is robust but lacks a qualified credentialing expert? Maybe day-to-day statement activities are consuming more time than planned and credentialing needs take a backseat? Don’t let a lack of time or knowledge allow credentialing-related denials to hit your and your client’s bottom line.

Now back to the questions above. If you answered yes to any of the scenarios, your company could benefit from additional credentialing resources. So how can billing organizations efficiently manage their day-to-day billing activities with credentialing duties that arise? Today’s medical billing professionals need the right partner. An experienced partner can easily simplify provider onboarding and credentialing. Extra resources in the form of credentialing experts can offset your workload, allowing you to optimize your internal resources. They’ll take on routine, time-consuming tasks off your hands so your staff can focus on other revenue-generating activities. Think of outsourced help as an extension of your office.

Finding the right partner is simple. Credentialing services from TriZetto Provider Solutions, a Cognizant Company, simplifies the credentialing process so your staff can focus on other revenue-generating activities. Our seamless extension of your in-house team provides the knowledge and payer experience to help navigate pandemic-related changes. We offer state-of-the-art software in the form of an automated, intuitive portal to simplify onboarding processes and remedy inefficiencies. This behind-the-scenes assistance will allow you to re-focus your resources while upgrading your client offerings. Get started today by learning more about services from TPS.