Streamline Your Credentialing Process

How to Streamline Your Credentialing Process

October 25, 2024
Posted by Cherrica

How to Streamline Your Credentialing Process

The credentialing process can often present multiple challenges that affect timelines. However, you can avoid or prepare for certain situations in advance to create a smoother credentialing experience.

On average, provider credentialing has taken 120-150 days during the COVID-19 pandemic. Delays often increase when the necessary documentation is incomplete or submitted late. You can avoid these common issues by following the tips below.

1. Respond Promptly to Consultant Requests

Credentialing requires teamwork, so respond to your credentialing consultant’s requests quickly. Delays in requesting documentation will affect your credentialing timeline, leading to slower approvals.

2. Keep Business Documents Consistent

Ensure that all legal documents—incorporation papers, bank account details, and bank letters—use the same legal business name and address. Even minor inconsistencies, like spacing or punctuation errors, can flag an application for denial and cause delays.

3. Keep CAQH Profiles Updated and Accurate

Update each provider’s CAQH profile regularly to maintain accuracy and attest to it on time. This step prevents the need for corrections later on and speeds up approvals.

4. Prepare for Unique Scenarios

While we work to anticipate the information payers may request, unique scenarios sometimes arise. Occasionally, payers may request additional information to complete your enrollment. Staying prepared for these requests can help prevent further delays.

5. Plan for Billing and Reimbursements

Think about your billing start date and when you expect reimbursements. Remember that even after receiving a contract, some payers may take up to 45 days to upload the agreement into their system for in-network billing.