Many people don’t know the difference between the credentialing and provider enrollment roles in business. That’s not surprising, as most people don’t have the need to know. You may, however, be surprised at the number of those in the healthcare industry that do not know the difference. While it is true that the two jobs are intertwined, there are distinct differences between the two that I'd like to make clear in order to help clarify why the enrollment specialist is often confused with a credentialing specialist.
Enrollment professionals frequently hear providers voice this common misconception. Providers often assume that once they are credentialed, they have completed the enrollment process and no more needs to be done. They sent in a multitude of signature pages, document copies, log-ins, and a large quantity of personal information to their enrollment specialist to complete enrollment. They patiently waited 90 to 180 days through the credentialing process, during which all information was verified, documented, and presented to a credentialing committee for final approval to the network as a participating provider. But wait, it’s not over yet.
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