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