For years, the healthcare industry has grappled with long, unorganized, and complex hiring and onboarding processes. In fact, the traditional process can take up to 4 months due to all the manual labor involved and the waiting times associated with primary source verifications. One solution healthcare firms should look to – in order to reduce turnaround times, costs, and overall inefficiencies – is outsourcing their medical credentialing. 

What is Medical Credentialing?

Credentialing refers to the process by which healthcare providers verify that nurses and doctors are properly trained, certified, and qualified for their positions. It’s a process that all medical professionals must undergo on a regular basis. Medical credentialing can ultimately be seen as fact-checking for recruits, and it is vital in healthcare because it ensures each professional hired has the adequate qualifications and degrees needed to not only do the job but be legally-apt for it. This is why credentialing is key to avoiding compliance issues within the healthcare system.

There are two main types of medical credentialing: Onboarding and Payor. Onboarding credentialing, also known as physician credentialing, consists of taking a comprehensive and detailed look at a candidate’s background, education, training, certification, career history, and beyond. Payor credentialing is the process of ensuring that a provider continuously meets all requirements and maintains compliance with a specific insurance provider. 

With how complicated the credentialing process can be, here are five reasons why you should outsource your credentialing, especially to a credentialing partner that can automate and simplify the process for you.

1. Increase ROI

Did you know that credentialing can cost facilities around $20,000 a year per candidate? By outsourcing the entire process to a credentialing partner, healthcare companies can considerably reduce costs, paperwork, and the need for manual or additional labor, which allows them to redirect their resources to more important areas of the business. A healthcare company found that facilities can save 20% to 80% in costs when outsourcing to a technology-enabled credentialing partner instead of in-house credentialing. With less time spent on the credentialing and onboarding process, healthcare organizations can reduce overall costs, focus on business growth, and achieve greater returns on investment (ROI).

2. Reduce Human Errors

Credentialing comes with many challenges and hardships, which become even more pronounced when an organization’s in-house credentialing process is done manually. Because credentialing requires constant fact-checking on countless certifications, degrees, and a multitude of documents per applicant, it’s easy to get overwhelmed and make a mistake. The manual process can lead to a myriad of human errors that can negatively impact the entire process and your company. All it takes is one misspelling, one wrong call, or misplacing one document to accidentally turn down a qualified candidate or extend an offer to an unqualified candidate. Outsourcing a credentialing partner can reduce the number of errors that are common with manual credentialing, thanks to the presence of specialized staff and automated software. Make sure to look for a partner with an automated credentialing system that can conduct real-time background, verification, education checks, and follow-ups. This will, in turn, not only reduce the number of complaints, complications, and costs associated with manual credentialing but also improve speed-to-hire and simplify the process.

3. Maintain Compliance

It’s common for hospitals, clinics, agencies, and other small healthcare facilities to work with a variety of providers. But, because each institution has a different set of requirements, keeping track of everything in-house and maintaining compliance gets increasingly difficult with every new provider. If even one requirement is missed, not met, or not properly verified, it can result in serious consequences for both the candidate and the business. Candidates can lose their license and career, and businesses can get hit with lawsuits and malpractice claims. To add to the complexity, candidates will need to re-attest their credentials every 90 days, a standard under payor credentialing. Outsourcing a credentialing partner will help you navigate each payor’s fluctuating processes so that your candidate can be credentialed correctly and start receiving payments on a timely basis.

4. Improve Turnaround Times

Traditionally, it can take healthcare businesses around 120 days to verify and check the qualifications of an applicant in-house. The process can become even more lengthy if you work with multiple providers due to all the varying compliance requirements. This time means extra labor for your team and more money spent. It also means that part of your staff will be working on credentialing candidates instead of their main tasks, causing unnecessary project delays. Outsourcing to a credentialing partner will allow you to greatly improve turnaround times, both for projects and onboarding. With the right automated credentialing solution in place, an outsourced credentialing partner will be able to credential your candidates in as little as 10-15 days*. 

5. Boost Efficiency

It is not surprising that many healthcare businesses have disorganized and unsystematic processes. With so many departments and unexpected developments in every turn, things can often become chaotic – especially when spreadsheets, paperwork, and documentation that need to be regularly updated are spread in multiple formats across different teams. The lack of organization paired with the constant need for updates will result in a lot of time being spent just trying to make sense of your files. An outsourced credentialing partner will deal with all this documentation on their end, saving your teams a large amount of time and labor. The right partner will help you check, verify, update, and revise all the files to make sure everything you have is up-to-date. With credentialing taken care of, your team will see improvements in efficiency and productivity.

Key Takeaways on Why You Should Consider Outsourced Credentialing

In-house credentialing is a tedious and demanding process that takes time, labor, and money away from your business. If proper processes are not established, you’ll see negative impacts on the efficiency and productivity of your business. To avoid all these negative ramifications, healthcare providers should look for a credentialing partner to better manage their candidates and data. Organizations that are able to outsource their credentialing to a partner can expect to reduce their overall costs, optimize their onboarding efforts, and ensure compliance with their multiple providers. 

Tollanis Solutions can help alleviate the burden your healthcare organization is facing by managing your credentialing process from start to finish. Interested in learning more? Contact us today.

*Stats taken across all 10k users that have been onboarded.

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