It can take more than a year to complete the enrollment process with a payer. This has a profound effect on a hospital’s ability to recruit providers, deliver care to patients and submit claims to payers. One solution to the enrollment problem is to achieve delegated credentialing status. Once delegated, a hospital can address many of the issues with enrollment. However, this solution is restrictive and can be challenging to complete successfully. CredSimple, a WHS Industry Partner, has written an educational article outline three things to know and get right about the process. They are:
- Know the contractual responsibilities that come with delegation;
- Understand the regulators and why they matter to delegated credentialing; and
- Know the standards you will have to meet in order to pass your initial and annual audits.