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Susan Ward

By: Susan Ward on June 9th, 2015

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3 Best Practices to Master Payor Enrollment Efficiency NOW

Payor Enrollment | Payor

Want to secure timely payments and ensure a steady flow of income? (Of course you do.) But what do you do if your information is not accurate, timely, and thorough? Well, for starters, you’ll delay the processing of your applications for approval in provider networks, which can have several repercussions (including losing new patients!) because you are not In-Network or having to write off huge amounts due to non-network status.

At symplr, we like to think of ourselves as the masters of provider enrollment efficiency, so we've outlined the top three best practices for timely and successful payor enrollment here.

1. Start your payor enrollment process IMMEDIATELY.

Individual payor enrollment should start as soon as you hire a new healthcare provider. That means if you’ve been putting it off, stop reading right now and go take care of it! It’s okay, we’ll wait.

The enrollment process can be long, so begin as early as possible to avoid unnecessary delays. The faster you process your new provider applications, the faster they'll be approved – and the faster they’ll be able to move forward as valuable contributors to your organization's success.

2. Get records together – in advance.

Even before you make the hire, you can start preparing for a smooth enrollment. Different payors require different information, but you can request ALL of this information in advance. It’s like we always say - knowing what you need for each payor is half the battle.

You can use provider databases to collect consolidated information, but ideally, your providers should manage their own data and be responsible for releasing additional information. Still, you can make sure practitioners know (in detail!) exactly what information is required for a timely submission and approval, plus any deadlines for completing enrollment.

3. Organization is huge.

After collecting the documents for provider enrollment, you'll need to consolidate them into one big package. Creating one central archive for storing this information is a great practice, and can maximize your healthcare organization’s efficiency. 

Using credentialing solutions (like those offered by symplr!) can help you streamline your payor enrollment and recertification. This is the Digital Age, after all: Harness the power of technology to create a secure, scalable archive to store and manage important documents. With an easily-accessible digital archive of your provider records, you can ensure efficient and accurate submissions to multiple payors – with just the click of a mouse.

The Bottom Line: Your Bottom Line

The accurate and complete submission of your provider information is essential for successful payor enrollment – and payor enrollment is critical to revenue. An organized provider enrollment system can help you eliminate delays and remove any obstacles standing in the way of your reimbursements and payments. 

To learn more about how symplr can help you develop a secure, scalable, and efficient process for payor enrollment, contact our experts today!


About Susan Ward

At symplr, Susan Ward is the Director of the Payor Enrollment Service product line. With 20+ years’ experience in physician practice management and provider enrollment, Susan is responsible for enrollment operations and relationships with Healthcare Systems, Hospitals, Physician and provider groups focusing on increasing the efficiency of provider onboarding during acquisitions, employment or new practice start up. Her previous experience includes over nine years at Community Health Systems in Franklin, TN, where she served as the Manager of Provider Enrollment, Acquisitions and RHC Enrollment. Her strengths in organizational structure, problem solving and relationship building, as well as her background and knowledge of CMS guidelines, are an asset to Payor Enrollment Services.