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Credentialing
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It seems the entire world is either embracing or demonizing artificial intelligence and the powerful automation that accompanies it. For healthcare organizations, the efficiency and impact of automated credentialing, however, feels like a big hug.
Automated credentialing offers a reliable and consistent process for completing tasks from provider exclusions monitoring to enrollment. Real-time views of critical processes, deadlines, and expirations ensure healthcare providers across all teams are updated of changes or looming deadlines. The result is efficiency, accuracy, and prioritization that frees staff to tackle important tasks.
What Is Automated Credentialing?
Automated credentialing is removing the tedious, manual tasks involved in the healthcare credentialing process to increase speed and reduce mistakes. What can be automated? Nearly anything! Software can send reminders when a license is going to expire or when recredentialing is imminent. It can automatically pull information from exclusion databases, such as the Office of the Inspector General’s List of Exclusions for Individuals/Entities (LEIE) and SAM.
It’s all about time and accuracy. A 2023 MedTrainer poll revealed that most healthcare organizations take 10 hours or more to credential a single provider. Automated credentialing is all about accelerating and streamlining enrollment, verification, re-credentialing, and reporting processes while helping organizations keep up with ever-changing governmental and payer regulations.
WEBINAR: How To Speed Up Your Enrollment Process
5 Must-Have Automations for Your Credentialing Process
1. Reminders/Notifications
Instantly see when licenses are expiring via automatic notifications starting 180 days from recredentialing. Reminders are sent to both the provider and credentialer along with prompts to upload documents that are required based on role, department, and location.
2. Exclusions Monitoring
Automate federal and state exclusion checks to run every month for every provider without manually searching the database yourself. Automated credentialing systems can monitor OIG/SAM and state exclusion databases and track changes within the software. If an exclusion is found, the platform instantly notifies the credentialer of the flagged parties.
3. License Verifications
Professional license verifications can take hours – unless you use automated credentialing. DEA and select state license verifications can be automatically completed and monitored. Eliminate jumping from website to website, waiting for documents to download, reuploading, printing, and filing. Information is automatically added to your automated credentialing software, which reduces the risk of typos or other inconsistencies.
4. Tracking/Reporting
Customize reports and schedule for automatic daily, weekly, and monthly distribution. Know the information credentials are waiting on, verified data, enrollment progress, and more. Instant report access allows you to more quickly and easily explore the data you need to make decisions, increase visibility into gaps and upcoming action dates for providers, locations, and insurance payers.
5. Electronic Signature
Capture multiple signatures with ease. Automated document multi-signatures reduce the back and forth required for privileging. Documents can be sent both internally and externally for signatures making it simple to gather signatures from busy governing board members. Easily view signature status and save, export, and schedule reports to show where documents are in the approval process.
Embrace Automated Credentialing: The Wave of the Future
The sheer volume of credentialing tasks makes automation a natural fit. In fact, automation is a top trend for healthcare in the McKinsey Technology Trends Outlook. Leading healthcare organizations are already embracing automation to streamline administrative and operations workloads. Increasing efficiency in the credentialing process will get providers in front of patients faster and increase an organization’s revenue.
Credentialing software, such as MedTrainer, puts all the data you need to make business decisions in one place. From provider data and files to upcoming action dates and automatic reminders, digitization offers a single place to enter, import, and store mandatory provider information and documents based on NCQA guidelines.