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Credentialing Services for Physicians and Hospitals

Physician Credentialing is Essential to the Revenue Cycle Process

As hospitals and physician practices employ more medical professionals, the proper credentialing of those professionals becomes increasingly important to the entire revenue cycle process.

A tremendous amount of reimbursement, legitimately due to hospitals and medical practices, is lost due to incomplete, incorrect, or delayed completion of required credentialing. And that is not entirely surprising in that credentialing is voluminous, varies by payer, with payer requirements changing over time.

Keeping Up with Physician Credentialing Requirements is Challenging for Hospitals

It is therefore very difficult to keep up with credentialing requirements, and hospital staff is understandably focused on new provider employment and contracting, and is often not focused on proper credentialing. But as proper credentialing is a threshold requirement in order to establish claims reimbursement for a given payer, credentialing is a critical part of the overall revenue cycle management process.

A Dedicated Physician Credentialing Department

Precision has a dedicated credentialing department, with significant experience in credentialing, focused on making sure that this all-important but often overlooked requirement is properly and timely managed. Hospitals and physician practices that engage Precision to provide credentialing support for their providers can be assured that all requisite credentialing work is effectively and professionally completed as it should be, fully supporting underlying revenue cycle processes.

"My pediatric practice, Children's Clinic, has worked closely with Precision for many years in an effective partnership that has contributed greatly to the management of our practice. In order to best serve patients, the "business side" of things must run extremely well. Precision appeals insurance low pays on drugs and provider services, communicates coding updates and specialty-related and billing changes, tracks office collection of copays and patient balances, compares our coding levels to national distributions and identifies our denial and rejection issues, to name just a few. Monthly meetings with Precision allow us to review month end reports, identify opportunities for improvement and constantly "raise the bar" on our performance as a practice. In today's difficult economic environment, Precision is a business partner we can count on."