Payor enrollment is a diverse and ever-changing process. With so many rules and regulations in place, it can take several weeks - and even months - to get applications approved. By developing an efficient payor enrollment process, you can ensure your provider’s applications for medical staff appointment and privileges and enrollment in health plans are processed as quickly as possible.
When it comes to processing enrollment applications, there are many requirements for hospitals and health plans, including Centers for Medicare and Medicaid (CMS) and state regulations, as well as requirements established by various healthcare accreditors. With so many rules and regulations in place, it can be difficult to navigate the payor enrollment process—let alone get applications approved in a rapid manner.
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Valuable Insights for Provider Credentialing and Privileging Teams When it comes to ensuring the physicians at your medical hospital or healthcare organization provide high quality care, your first line of defense is a thorough provider credentialing and privileging process. Making sure your medical services professionals (MSPs) have access to up-to-date provider information is just one of several important steps to mitigating the risk of negligence in credentialing and privileging.
As you know, provider credentialing and privileging is crucial to your compliance program – and to protecting the safety and welfare of your patients. To ensure quality patient care and help shield your organization from negligent credentialing lawsuits, start by making sure your teams have access to a reliable, up-to-date provider privileging database. Then, follow these steps to further reduce your healthcare organization’s risk of negligence in credentialing and privileging: