How Critical is Credentialing and Contracting in Urology Practice?

Credentialing or Insurance Enrollment alludes to, the tedious, delay-filled, disappointment producing need, and is often the last thing on a Urologist’s mind when running a practice. Tragically, it is frequently ignored by your staff and could truly be a capital punishment to your practice.

The Regressive Effect of incorrect Credentialing:

A solitary rejected, or missed, re-credentialing, or revalidation application could result in thousands of unpaid claims. What number of patients does a Urologist see every day? In seven days, during the month? What kind of medical billing and coding requirement is to be followed in case of incorrect credentialing?

Now envision having each one of these claims rejected as a result of a revalidation error or re-credentialing oversight. Each related claim will be set on hold until the revalidation is finished. This postpones reimbursement and each claim needs to be resubmitted and more repayment delays.

The additional time that goes in the wake of seeing the patient, the more is the probability that some event will make the claim be denied. All of this results in more delays and denials, all in light of the fact that credentialing was not up to the mark.

An Expensive Scribe

A new Urologist who can’t see patients because of credentialing is as valuable as a scribe. As a new physician in the field of Urology, you should expect the credentialing & contracting to take at least 90 days, and a month or so longer for a graduating resident or fellow.

This is around four to five months of payroll costs of an expensive employee without the benefit of incoming revenue to offset it. Every delay in gathering data, submitting it, and needing to correct medical billing and coding errors, serves to push the timetable back even more.

Rejected Claims Shoot up

Denials soar in light of participation issues. At the point when a Urologist’s status is being referred to on account of credentialing or re-credentialing, the reaction to claims can differ. The post result of which is an increasing count of denied claims. Limit this by taking care of all credentialing or re-credentialing in an opportune, exact, and capable way.

With so much at stake in regards to credentialing and re-credentialing, every mistake, delay, or billing error has significant monetary repercussions that harm the Urology facilities’ bottom line in a negative manner. Don’t take a risk on this critical step by turning it over to well-meaning staff, which try their best but often encounter unexpected problems or are simply stretched in too many directions.

Rather turn it over to specialists who spend significant time in credentialing, doing it consistently throughout the year for a large number of healthcare services experts around the country. You’ll be doing yourself and your association’s huge support. Urology Practice Specialists in the current business scenario have to face undue losses, which is not appended to their core work but related to the core services, which the additional healthcare service experts.

Right from filing the appropriate insurance claim, to pin-point accuracy in credentialing and contracting, one simple mistake leads to delayed or denied claims. To keep up the pace of your revenue cycle, it has indeed become a necessity for Urologist to hire and attain the services of expert Urology billers and coders who are specialists in tailoring all claims appropriately, ensuring there are no delays and denials in reimbursement due to incorrect coding and billing, credentialing and contracting.