Question Who outsources their credentialing?

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I am the Billing Manager for a physician owned practice that currently has 1 location with 12 providers. In early 2023 we will be opening a second location and adding more providers. Currently I handle all of the credentialing and it is starting to become more difficult to keep up with. Not only do I handle insurance credentialing but I also have to keep up with hospital privilege credentialing. What company do you use? What are the pros and cons?
 

csperoni

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When my office was private practice, and 3 clinicians, I did it myself. We joined a very large healthcare organization that outsources. But there is still an internal corporate office that everything goes through.
To be honest, the amount of time I have to spend corresponding with this internal corporate office and outsourcing company, I feel like I could have just done it myself and much quicker.
I have no idea of the cost for the outsourced credentialing. I will say having your insurance credentialing incorrect and/or delayed can have a HUGE impact on your bottom line. If I was still in a private practice, but with too many providers to do myself, I would lean toward hiring someone to do this that I could directly supervise. And I could also use that employee for other administrative work. Otherwise, I would want a credentialing company with great references (never personally came across any) and a good system of reporting everything back to me.
 

deeva456

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Hello I just saw your post. I did credentialing for 15 years, we had 20 cardiologists and five office locations. When I started doing credentialing, I didn't know much but over time I became an expert at it. it was 1993 and the internet wasnt available at the time or was just started to develop. Everything was on paper. You may want to have one person dedicated to doing credentialing, for me it wasn't a full time job but it did require to be organized and stay on track. I did all the hospital applications, renewing DEA, state license, radiology permits, insurance policies, onboarding new physicians, NPI applications, all insurance PPO and HMO applications/contracts. During the 15 years I was never late in submitting applications.



Good luck!!

Dolores
 
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laniwho

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Credentialing can be so hard on a practice. I have been credentialing for 61 different providers for about 2 years and I am thinking I finally have it worked out with spreadsheets, appointment reminders for licensing expiration dates, and the CAQH Proview is a huge help!

Our company charges $50 an hour for the credentialing
 
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