In order to maintain the quality of care, regulators have implemented physician credentialing. In physician credentialing, regulators verify several aspects about the physician that includes admitting privileges, education, insurance, professional references, work history, board certificates, and many other aspects. For physicians, the challenge is maintaining the up to date information on its experience, references or certificates; hence outsource physician credentialing teams become vital to the process.
The affordable care act 2010 has substantially increased the requirements of physician credentialing. The demand for compliance by regulators is to reduce fraud and abuse, currently, most of the physician credentialing is required by payers, federal government and accreditation agencies. Individual credentialing is required for each payer, and each of the payers has their own internal timeline for credentialing.
For any physician today, it’s important that they start credentialing process as early as possible that takes anywhere between 90 to 180 days. Outsource Physician credentialing teams can keep speedup your credentialing process by keep the information up-to-date periodically and analyze the missing information affecting your pay.
Most payers have a uniform credentialing program, The Coalition for Affordable Quality Healthcare (CAQH). Hospital credentialing can no longer be used for physicians credentialing it was possible earlier.