Blog /

Faster Medical Credentialing = Better Provider Experiences & Network Growth

By

Verifiable

We can all agree: providers are the cornerstone of healthcare. 

Today, more than ever, providers are inundated with options for where to work. Between provider shortages—with a physician shortage up to 86,000 by 2034—and increased competition, securing top provider talent requires a solid network growth strategy and greater provider satisfaction. 

Ultimately, provider and payer organizations need to work harder to attract and grow their networks. One overlooked lever for provider growth is to remove the unpaid, un-fun administrative work from the provider’s plates. Medical credentialing is arguably the most burdensome admin roadblock for providers.

A streamlined physician credentialing process that fast-tracks the provider’s ability to work but also impacts their initial perception and experience with a provider or payer organization is a win-win. Credentialing providers promptly, with transparent timelines, is an often overlooked and selling point worth highlighting. 

Check out our guide, The Influencing Factors of Provider Data Strategy on Provider Network Growth for more ways to attract and retain top physicians.

Streamlining Medical Credentialing for Providers: Why it Matters

More efficient onboarding and physician credentialing have a trickle-down effect across numerous departments. Faster physician credentialing—with the aid of automated medical credentialing software—improves provider satisfaction, allowing them to hit the ground running.

Here are 3 key benefits of streamlined medical credentialing for providers: 

1. Swift Transition to Patient Care

Efficiency in credentialing and enrollment is a make or break for providers. By minimizing the time spent on administrative processes, providers can quickly transition to what they do best—caring for patients. This not only accelerates their ability to start earning but also significantly improves patient access to healthcare services.

2. Simplified Intake Process

The initial step of gathering provider information should be as straightforward as possible. With credentialing software solutions like Verifiable, the intake process is condensed into a single, simplified form, making it easier for providers to submit their information. This eliminates the barriers to entry that could deter providers from completing their applications. Simplified physician credentialing checklists and intake forms help more providers successfully join the network without getting lost in the administrative slog. 

3. Automated Credentialing Maintenance

Once a provider’s data is in the system, there’s no need for them to actively manage or monitor their credentialing status, or re-submit their information. Advanced medical credentialing software systems should handle the ongoing monitoring and re-credentialing tasks by pulling primary source data as needed, automating data entry, and improving Medical Credentialing Specialist efficiency. This level of automation relieves providers from the burden of paperwork, enhancing their work satisfaction and ability to focus on patient care.

Did you know? When insourcing credentialing, Medical Credentialing Specialists with automated software, like Verifiable, can process more than 3x the number of credentialing events per month.

In short: 

  • Providers can begin seeing patients—and generating revenue—much faster when the credentialing and onboarding are streamlined and software-supported. 
  • The credentialing intake process should be nearly effortless. Technologies that allow for a single-form intake, like Verifiable, make it more attractive for providers to join and stay within a provider network.
  • Providers should be free from the responsibility of ongoing credentialing management. Leveraging medical credentialing software to aid with provider enrollment, physician credentialing, ongoing monitoring, or re-credentialing lessens the load.

Improving the credentialing process not only enhances the provider experience but also has a proven, positive impact on patient care. By reducing administrative hurdles, healthcare organizations can uphold more satisfied, focused, and highly qualified providers. This strategic approach to medical credentialing fulfills the broader goals of healthcare organizations.

Streamlining Medical Credentialing for Payers: Why it Matters

Faster, more efficient medical credentialing doesn’t just benefit providers and accelerate network growth. It benefits payers too. Verifying provider credentials is a resource-intensive process that affects the payer's (and provider’s) bottom line. Provider enrollment and the entire medical credentialing process needs to run smoothly to keep all parties on track.

Did you know? The industry standard for a payer to credential a provider is approximately 120-160 days.

While waiting for credentialing to be completed, providers cannot bill that payer for services—limiting the patients they can see and the number of payer cases processed. For this reason, obtaining delegated credentialing agreements with payers, digital verifications, and automated credentialing systems are make or break.

How improved onboarding, enrollment, and credentialing benefits payers: 

  • Minimize Revenue Disruption: Faster credentialing ensures providers can bill for services sooner, reducing revenue interruptions for both providers and payer organizations.
  • Keep Providers Engaged: Faster onboarding and credentialing processes ensure providers stay engaged with timely status updates. This reduces the risk of providers dropping off or opting for other payer networks due to a disorganized enrollment experience.
  • Reduce Administrative Burden: Automated credentialing software like Verifiable reduces the administrative burden on payer organizations. By maintaining transparency with providers and adhering to NCQA guidelines, the process is fast-tracked, freeing up resources for other essential tasks.
  • Increase Appointment Availability: Accelerated credentialing leads to more providers joining the network faster, resulting in increased appointment availability for patients. This drives revenue through more billable encounters and enhances member satisfaction by reducing wait times for care. It also helps to manage costs by preventing the escalation of health issues.
  • Enhance Provider Network Diversity: Streamlined onboarding enables payer organizations to onboard a diverse range of providers efficiently. This diversity enriches the provider network, offering patients access to a broader spectrum of healthcare professionals and specialized services. It also increases billable opportunities for the payer.

In short: 

  • Credentialing automation minimizes payer and provider revenue disruption, ensuring timely access for patients and billing for services.
  • Enhanced provider engagement and retention through efficient enrollment processes better secure providers for payers.
  • Diversification of the provider network enriches services and strengthens payer offerings, contributing to member growth.

TL;DR: Increase Provider Satisfaction with Faster Credentialing

  • Faster credentialing ensures timely billing for services, minimizing revenue disruption for payers and providers.
  • Efficient onboarding processes enhance provider satisfaction, engagement and retention, securing more providers for payers.
  • Streamlined credentialing diversifies the provider network, enriching services and strengthening payer offerings.

Verifiable's automation of medical credentialing and provider enrollment isn't just a time-saver—it's a game-changer. By removing administrative red tape, Verifiable accelerates provider onboarding and enrollment, ensuring faster access to patient care while minimizing revenue disruptions. With simplified intake processes and automated medical credentialing, Verifiable boosts physician satisfaction and enhances provider network growth.

More articles