Medical practices are unique in their specific area of business, but just like any other business, medical practices cannot survive without a solid revenue stream. Credentialing and contracting play a vital role in any practice’s financial foundation, as these tasks must be completed properly in order for providers to be able to work without interruption and receive reimbursement as they should. This is one area where partnering with a service that is focused on credentialing and contracting can be particularly beneficial to your practice’s success.
The Problem
Credentialing involves gathering and verifying your professional records in order to prove that you are indeed qualified to practice medicine. Contracting refers to the process of applying for and obtaining participation in health insurance plans in order to receive payment. Credentialing and contracting can be a time-consuming process, as well as complicated and confusing as different organizations have different processes. It can be difficult for a practice to keep track of all the requirements, being sure that each of the different processes is managed adequately. Unfortunately, it’s rather easy for practices to get confused and off-track, missing important details and jeopardizing their ability to work and get paid. This is particularly concerning because there are potentially serious consequences if this task is not completed properly.
The first consequence is a loss of revenue. Payers can reject claims from providers who aren’t properly credentialed or contracted. Obviously this affects your revenue stream and causes problems for your practice’s bottom line, jeopardizing your ability to continue to operate. The second consequence is poor patient experience. Having your credentials in order is essential to being able to give your patients outstanding care. If your credentials are out of order, you won’t be able to get hospital privileges, rendering you unable to care for your patients when they are in an inpatient care situation. Patients rightfully expect their providers to be able to care for them no matter the setting and they will likely look for a new provider if they learn their current provider is unwelcome in the local hospital.
The Solution
Catalyst Consulting’s staff of healthcare contract specialists use a hands-on, process-driven approach to streamline your credentialing and contracting efforts. They help with contract procurement, evaluation, negotiation, compliance, credentialing, and payment auditing, guiding you from the beginning of getting set up with payers all the way through ensuring that you are being paid as you should. They also provide active maintenance of your contracts and credentials, meaning you don’t have to worry if these items are up to date or not, preventing lost money and headaches. Catalyst also tracks and monitors the charges that are allowable versus what you’re actually receiving so that you won’t miss out on money owed. This ensures that your practice will always get paid exactly as it should, keeping your revenue stream strong and your practice operating and thriving. Finally, Catalyst will perform mock audits and help you prepare for audits from various accrediting bodies, helping you to feel prepared and avoid the concern that often comes with pending audits.
Credentialing and contracting are vital to your success as a provider, but can also prove complicated and time-consuming. Don’t go it alone. Henry Schein SolutionsHub offers Catalyst Consulting to help your practice efficiently take care of these tasks from starting the credentialing and contracting phase to making sure you’re receiving every dollar owed. Are you ready to learn more or get started? Visit henryscheinsolutionshub.com or call 833-433-2482.
