RCM tip of the day: Integrate provider-payer contract and credentialing data

Credentialing software — which helps manage the process of establishing a provider's qualifications, board certifications, work history and references — should be integrated with provider-payer contract data, said Scott Friesen, CEO of Newport Credentialing Solutions, an outsourced provider for privileging and credentialing solutions.

He said integrated data helps hospitals generate revenue faster.

"Cross-team access to provider data ensures everyone involved in getting a payer ready to bill is on the same page. The ability to track where a contract is each step of the way and set automated alerts for when contracts are complete means the credentialing team can immediately begin working on privileging and then enrollment," Mr. Friesen told Becker's. 

"Integration greatly reduces the time frame it takes for all of this to happen in comparison to each process being separate and disconnected. And the faster a provider is enrolled, the faster they are able to generate revenue," he said.

If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series.

 

More articles on healthcare finance:

Spending on California ballot initiatives over hospital charges exceeds $7M
California spent $4B on Medi-Cal coverage for potentially ineligible people, audit finds
Mississippi hospitals end Medicare Advantage agreements over declining reimbursement

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Top 40 Articles from the Past 6 Months