Learning
Credentialing
Compliance
If healthcare credentialing bottlenecks, duplicate tasks, and manual data entry are stalling revenue and holding your organization back, it’s time to regain control. With automated credentialing, there’s no excuse for many of the credentialing-related delays and errors that prevent providers from practicing. Eliminating these — and result in an average loss of $9,000 per day in provider revenue.
Can automated credentialing really do that? Sure, automatically completing redundant tasks that don’t require human intervention and eliminating delays on handoffs between departments will shave days off your credentialing time, so providers are seeing patients faster.
In this article, I’ll show you how automated credentialing works as part of healthcare credentialing software and give you a list of the five must-have credentialing automations.
How To Speed Up Your Enrollment Process
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.
How To Speed Up Your Enrollment Process
How Does Automated Credentialing Prevent Bottlenecks and Duplicate Tasks?
Automated credentialing helps healthcare organizations break down bottlenecks by standardizing workflows, auto-filling provider information, and flagging missing information or gaps. Automation bridges the gap that can happen between steps, keeping the complex process moving. The gap where a credentialer has to switch systems or complete a task manually is when they get distracted or take a break, causing unnecessary errors or delays. Using an automated process also eliminates manual handoffs and duplicate tasks, which are common causes of delayed credentialing and lost revenue.
Here’s what you can expect with automated credentialing:
- Faster time to revenue by automating the slow, manual processes most prone to error, getting providers fully credentialing and ready to bill sooner.
- Improved accuracy with powerful data integrations and automatic form fill that eliminates error-prone data entry that causes rejection of enrollment applications.
- Happier staff who will have more free time to spend on high-value tasks rather than tedious manual data entry and frustrating duplicate work.
- More predictable turnaround times as standardized processes replace spreadsheets, email threads, and one-off workarounds.
5 Must-Have Automations for Your Credentialing Process
1. Reminders/Notifications
Never let a missed manual follow-up delay credentialing again! Instantly see when licenses are expiring via automatic notifications starting 180 days in advance. 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 OIG exclusion checks to run every month for every provider without manually searching the database yourself, so you can be sure your credentialing will never be stalled by a missed exclusion. 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 and Board Certification Verifications
Automatic professional license and board certification verifications eliminate jumping from website to website, waiting for documents to download, reuploading, printing, and filing. Automated credentialing software retrieves the license or certification image and adds relevant data to the platform for a professional to verify. This saves time and reduces the risk of typos or other inconsistencies that can stall credentialing and ultimately revenue. Make sure the software you choose offers direct access to licensing boards and certifications in all 50 states.
4. Tracking/Reporting
Customize reports and schedule for automatic daily, weekly, and monthly distribution. With the information you. need delivered on a schedule you set, you can check enrollment progress, document status, 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, so you can stay on top of credentialing deadlines and keep revenue flowing on time.
5. Auto-Fill and Auto-Extract
With automated form filling and automated extraction, you can eliminate redundant data entry and completion of pages-long credentialing forms. Automated credentialing software can extract relevant data from HR forms, credentialing applications, privileging requests, and enrollment documents, placing it directly into the provider’s profile. AI-powered form mapping eliminates the need to manually map forms when you want to automatically populate data from the software to a form. These tools can speed up your process while ensuring greater accuracy, helping protect your process from slow-downs and preventing revenue stall.
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.
With intelligent workflows, automated verifications, real-time tracking, and AI-powered tools that classify documents, surface missing information, and reduce manual data entry, modern credentialing platforms like MedTrainer remove friction at every step to help credentialers work faster, more efficiently, and with less frustration from tedious manual steps. The result is a strong, reliable credentialing process that keeps administrators, providers, and patients happy, and makes your revenue cycle stronger than ever before.