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Making sure you’ve hired the right people for the job is essential to every business. Not having qualified employees puts service capabilities, productivity, and other aspects of the company at risk. This is especially true when it comes to credentialing in the healthcare industry.

Credentialing is the process of verifying that a healthcare provider’s documentation, certifications, and background are legitimate. It is incredibly important, as ensuring a physician is qualified for their position is essential for protecting the wellbeing of patients and the healthcare institution itself. For example, if your hospital grants privileges to someone who doesn’t have enough experience, the resulting damage can lead to costly negligence lawsuits; and no healthcare organization wants to deal with that.

However, as integral as the medical credentialing process is for hospitals, it is by no means an easy task. There are numerous problems that healthcare organizations can encounter that make credentialing a pain to deal with. This is especially true when they are understaffed and need to bring on more providers to alleviate stressful conditions. To prepare your establishment in advance, learn six of the most common credentialing issues in industry.

Starting Providers Before Their Credential Verification


As the purpose of healthcare credentialing is to ensure that a care provider has the right qualifications for their position, letting them start prior to the completion of their credential verification can lead to multiple problems. Overworked hospitals may feel tempted to grant a new provider their privileges as soon as possible, but by doing so, they may be placing the care of their patients in the hands of someone who is not qualified.

In addition to ensuring a practitioner has the necessary experience, hospitals must wait for other sources to be verified. Without performing thorough background checks, a healthcare facility may accidentally bring on an individual that has been debarred. For that reason, the credentialing board must not ignore peer references either, as they can reveal details about a provider that their education and training background may not.

Failure to Recredential Current Providers


Even if a healthcare provider has been credentialed once, that won’t be their last time. Recredentialing is also important, as credentialing laws and regulations can change over time. A provider may no longer meet the qualifications of a given state if legal changes occur, which may result in malpractice cases. Therefore, they must be updated regularly to meet the requirements of the state they are practicing in.

The Application Is Incomplete or Incorrect


There is an immense amount of information that healthcare providers must submit for their credentialing applications, and as a result, they may accidentally leave some information blank. Any incomplete applications will cause delays in the credentialing process and possibly even result in denied claims, which will lengthen an already long process. Always double check to ensure everything has been filled out!

Although an applicant may not leave anything blank, there’s no guarantee that all of it is correct. For example, they may write down incorrect contact information if they’ve moved recently. While this mistake may not be that bad, other errors, such as an out-of-date license, can be more severe.

Labor Issues


Healthcare credentialing is a time-consuming process. With countless physicians to keep track of, it can be very difficult if there are not enough staff members or resources allocated to the task. However, even if there are enough people on the credentialing team, the amount of work that must be done can still become incredibly stressful. As credentialing requires attention to detail to perform correctly, any accumulated stress can result in mistakes that will cost a healthcare organization time and money due to inefficiency.

An Inability to Properly Manage Time


Given how long healthcare credentialing can take for a single person, failing to meet deadlines can stall the process further. Poor time management can prevent a busy hospital from adding the new healthcare providers to its staff, meaning it is imperative for the facility to manage its time appropriately. 

Some of the things that can harm a facility’s time management are setting a start date for a provider before their credentials have been verified and the time it takes to exchange correspondence with insurance companies and primary sources.

Staying Up-To-Date With Credentialing Requirements


Lastly, a major hurdle hospitals must overcome during healthcare credentialing is the ever-changing requirements the industry is making. As requirements are growing stricter and specific, credentialing teams must stay up-to-date with the contemporary regulations. Additionally, it is imperative for staff to take state requirements into account, as they may differ based on location.

MedTrainer Can Resolve Credentialing Problems in Healthcare


Several of the credentialing problems in healthcare can be addressed by transitioning your hospital to digital software, which will eliminate human error, streamline the process, and provide other benefits as well. At MedTrainer, our software can solve the many credentialing issues your healthcare organization may encounter!

In addition to our healthcare credentialing software, we also provide a compliance training tracker and countless other systems to improve the productivity and wellbeing of your facility. For more information on MedTrainer or to schedule a demo of our software, reach out to us today!