As someone who manages or oversees provider credentialing and payer enrollment for your hospital or healthcare organization, you understand the value of maintaining efficient processes across departments to save time, reduce costs and ensure providers are granted privileges as quickly as possible. Health plans (also known as managed care organizations) strive for similar goals. Understanding the payers’ specific accreditation and regulatory requirements can help you and your team of medical services professionals further ensure timely processing of provider applications.
In the new, six-page white paper, Understanding Credentialing and Enrollment Processes: Healthcare Organizations vs. Health Plans, I explore:
- The processes payers conduct to evaluate and enroll healthcare providers
- Common challenges in provider enrollment and how to solve them
- Tips and techniques to achieve delegated credentialing
The intention of this white paper is to help readers understand the different perspectives and processes of healthcare organizations and health plans related to credentialing. It is my hope that this white paper will also help readers apply this knowledge toward improving provider enrollment, seeking delegated credentialing, if desired, and accomplishing other credentialing-related goals.