There are several reasons why a commercial payer, such as a managed care organization or health plan, may consider delegating all or part of its credentialing activities to qualified business partners such as IPAs, PHOs, CVOs, medical societies, even other health plans.
However, a growing trend observed by The Greeley Company is for hospitals and health systems to directly seek delegated credentialing from commercial payers. With the growing numbers of employed practitioners, hospitals and health systems are looking at delegated credentialing to speed up the provider enrollment process and reduce accounts receivable write-offs and claim holds which delay or decrease the revenues received from payers for the services provided to patients.
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[Editor's Note: This article originally appeared on The Greeley Company's blog.]