How to Streamline Your Credentialing Process

Throughout the entire credentialing process, there are multiple situations that may occur and can affect the timeline of a provider’s credentialing. Some of these situations can be avoided or prepared for ahead of time which will result in a much smoother process without delays.

The average timeline for provider credentialing has been 120-150 days during the COVID-19 pandemic time. This can be extended even further when the documentation needed for credentialing is submitted late or is incomplete. Delays caused by incomplete documentation or negligence can be easily avoided if you follow the tips below:

  1. Respond to requests from your credentialing consultants in a timely fashion. Please understand this process involves teamwork, and ifthe delivery of documentation requested is delayed, this will affect your credentialing timeline.
  2. Make sure that all legal incorporation documents, bank account information, bank letters etc. have the same legal business name and address on them. Be aware that spaces and punctuation do matter, if there are any inconsistencies the application will be flagged and denied, resulting in further delays.
  3. Make sure each provider’s CAQH is up to date, accurate and attested.
  4. Be prepared for unique scenarios to arise throughout the process. We try and work with you proactively to request all of the information the payers may need up front however, there are scenarios where additional information may be requested by the payer to complete your enrollment.
  5. Plan ahead and know when you expect to start billing out claims and receive reimbursements. Also bear in mind that in order to bill in network claims successfully, some payers can take up to 45 days to upload the new contract into their internal systems after the contract is received.

Utilizing these tips will help cut down any delays caused by human error and will allow your credentialing consultants to complete your credentialing in a timely manner.

We understand that provider credentialing takes patience and persistence, and that is exactly what TriumpHealth’s credentialing consultants deliver to each and every provider that needs our assistance. If you have any questions or want to learn more about TriumpHealth’s provider credentialing and medical billing services, please feel free to contact us at 888-747-3836 x 1 or email Madison at madison@triumphealth.com.