I have been in the payor enrollment industry for 27 years, so people often ask me how the industry has changed. Steadily, I say, with a few punctuations of accelerated change.
It doesn’t take too many trips down the chutes and ladders of payor enrollment checklists to realize there are a lot of unforeseen obstacles in our path. Sometimes it’s outdated forms. Sometimes it’s a missing pre-application to the application. Sometimes it’s bad instructions, and you end up sending the application to the wrong address.
Don't miss out on the latest on healthcare governance, risk and compliance.
It’s not every day that laws are passed unanimously, but that’s exactly what the Arizona legislature did when it passed HB2322. Requiring healthcare insurers to speed up the process of credentialing new providers into their networks, this bill is a welcome change.
Have you recently hired a healthcare provider to join your practice? Making sure the provider becomes enrolled with commercial and government insurance payors is essential to maintaining a steady patient base and cash flow to your practice. To ensure the enrollment process moves along efficiently and in a timely manner, you will need to submit the provider’s application and required documents as soon as possible to the top payors in your area.
Your staff is shrinking, the workload is growing and your healthcare organization has acquired a practice with 50 new providers. How do you get them onboard, enrolled with payors and credentialed by the end of the fiscal year?
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.