3 Common Provider Enrollment Mistakes To Avoid and Tips For Success

Do you want to attract many patients and improve your revenues in your healthcare business? If yes, you have to follow one of the most important processes called provider enrollment. Whether you want to provide insurance services, emergency medical services, rehabilitation services, or any other similar line of work, you have to complete the provider enrollment formalities properly to make a name for yourself in this business. 

The provider enrollment process plays a vital role in the financial health of your business. When done properly, you can use it to improve your cash flow, woo new patients and expand your business in the commercial and government insurance sector.  However, when you commit the following mistakes in the provider enrollment process, you are likely to incur heavy financial losses. You can also lose your patients, thereby causing a huge dent in your reputation. Here are the 3 common provider enrollment mistakes you should stay from: 

1. Not furnishing the entire information properly 

You should submit a full report of your past and present medical practice to the insurance company to know if you are eligible enough to be included in its provider network. All details related to your address, contact number, copies of the license to operate, complete profile of your patients, legal problems (if any) and other business–related papers should be submitted on time with your valid signature. Not completing these details can lead to a delay in processing your application. Eventually, your credentialing may be delayed or rejected, thereby causing you huge amounts of financial losses. 

2. Not starting early 

Many new medical services or healthcare services companies should start the provider enrollment application process quite early. You may be surprised to know that even if you outsource this process to an expert, it will take you about 4 to 6 months to be included in an insurance company’s network. If you are doing this process on your own, you will have to wait patiently between 8 and 12 months for all formalities to get over. So, you should always start the process of provider enrollment at least 3 months prior to setting up your practice. 

3. Not following up 

As you have already seen, it takes a long while for you to get your credentialing approval and get included in the network of medical providers of an insurance company. So, you should start following up with the company regularly, and be up-to-date on the status of your application. When you don’t follow up, you are unaware of the problems, and by the time you get intimated of the same, it may be too late for you. So being proactive, and constantly checking the progress of your application is the only way to stay ahead in this race. 

Some tips to successfully get provider enrollment credentialing 
  • Have a dedicated credentialing coordinator handle all communication with the insurance company, and track the status of your application. 
  • Ensure that your practice is attested with the CAQH ( Coalition for Affordable Quality Healthcare) to get quick and efficient provider enrollment credentialing. 
  • Ensure that all details about the physicians registered with you are updated and available for checking by the authorities. You should get their backgrounds checked completely, so that there are no problems with credentialing. 
  • Know about the latest rules about provider enrollment credentialing in your country, and ensure you follow them properly to avoid delays in the process.