What are Credentialing Issues and Resolutions?

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Clinicspectrum is a healthcare services company providing outsourcing/back office and technology solutions for 17+ medical billing companies, 600+ medical groups/healthcare facilities including hospitals, and hospital medical records departments.

The company is promoted by technical experts from diversified industries. In a span of 12 years, we have been able to transform several billing companies and healthcare facilities nationwide into efficiency engines. Our strategy is to build productivity through the use of technology, highly trained personnel who deliver results in a timely fashion, and customized consulting services. With resources composed of 52+ employees nationwide and 350+ back office employees overseas, we have found a solution for all the problems in running a medical billing company and medical practice resulting in better clinical records, revenue cycle, and administrative task management.

Services

Our back office expertise is in providing claims follow-up, credentialing, eligibility verification, appointment scheduling, filing of scanned medical records, claims entry, and payment posting.
Due to rising costs for all billing companies, healthcare providers and reduced insurance reimbursement rates offices should not burden their staff with tasks that can be performed by our team for a lesser fee along with better results. We use the strictest auditing methods to insure optimal outcomes for our clients and always guarantee confidentiality.

We are the sole proprietors of the medical billing back office, data entry, and call center services we provide. This allows us to streamline all our respective services into one effective solution for running a medical billing company, medical practice and a hospital billing department.

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What are Credentialing Issues and Resolutions?

  1. 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.

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