Category: Credentialing How Tos

Credentialing nurses and physicians assistants

The increased demand for nurse practitioners (NPs) and physician assistants (PAs) is a nationwide trend that is expected to continue over the coming years. The U.S. Bureau of Labor Statistics expects a growth of around 19% in nurse practitioners alone by 2020 — well above the national average. We’ve seen this trend reflected in an […]

Implementation

Implementation of new technology can seem like a burden, which is why we’ve been purposeful with how we’ve built CredSimple. Our goal is to unburden the credentialing process and to make implementation and use of our platform as efficient as possible. There are 2 distinct but interrelated ways our clients can use our platform: As […]

Why is Jessica so Frustrated? Jessica is a busy credentialing coordinator who has been in her role for 5 years. Today, she arrives at her desk to voicemails and emails from the provider relations department requesting status updates on credentialing for their new providers. By lunchtime, she has received more status requests. Every time she […]

Hospital recredentialing tip

With so many moving parts, hospitals — or any other clinical care organizations that employ or work with healthcare providers — must decrease any roadblocks to compliance and revenue cycles. Improving recredentialing efficiency is one way to do so. Cut Out Redundant Affiliation and Privileges Checks When it comes time to recredential providers, organizations can cut […]

We work with a number of health plans and we’ve learned a few tricks that can help reduce provider credentialing turnaround time. Reduced turnaround times increase provider goodwill, help operations improve revenue cycles, and ensure your members have access to the providers they need. The changes include increasing the efficiency of the approval process for […]

Reduce Credentialing Turnaround Time

If you’re constantly playing catch up when it comes to provider credentialing turnaround time, you’re not alone. For most health plans it takes 60 – 90 days to complete provider credentialing. This lengthy waiting period directly impacts cost and turnaround time. The good news is, that’s no longer necessary. Learn how you can: Eliminate redundant […]

Credentialing Requirments

In this series, we break down what you need to know about credentialing, re-credentialing and delegated credentialing. In today’s post, we cover the establishment of credentialing requirements (CR 3). In prior posts, we covered organizational requirements (CR 1) and credentialing committees (CR 2). But before we dive into the nitty-gritty of today’s installment, remember that […]

NCQA CR2

In this series, we break down what you need to know about credentialing, recredentialing and delegated credentialing. In today’s post, we cover the establishment of a credentialing committee (CR 2). In a prior post, we covered organizational requirements (CR 1), and in future posts we’ll cover credentialing requirements (CR 3 through CR 8) and delegation of credentialing […]

Centralized_Credentialing

Centralized credentialing can help eliminate repetitive work, improve revenue cycle, and lower credentialing costs for hospitals, facilities and practices. It also improves provider data integrity and facilitates delegation with payers. To take a deeper dive into the benefits of centralized credentialing, let’s take a moment to understand what centralizing means and what tasks should and […]

Founded in 1990 with the mission to systematically improve healthcare quality, NCQA is considered the gold standard when it comes to credentialing requirements. We think it’s important to understand and get the most out of the NCQA credentialing requirements. In this post, we’ll explore the six common mistakes we’ve seen healthcare organizations make as they endeavor […]