Thought Leadership

New Perspectives To Improve the Credentialing Industry

Provider Enrollment Case Study

Increased Revenue Through Pro-Active Provider Enrollment

In today’s complicated healthcare environment, it is critical that providers capture every billable dollar. Pro-active management of your revenue cycle, implementing an ACO based physician alignment program, and keeping up with the increased provider enrollment requirements and processing times is key to maintaining a healthy bottom line.

One area where providers lose revenue is provider enrollment. Application processing, tracking, and diligent follow-up is difficult to manage and many providers don’t realize that a successful provider enrollment initiative needs to be a pro-active provider enrollment initiative. Additionally, providers are realizing that they can generate incremental revenue by reducing provider enrollment timeframes as well as enrolling allied health providers.

At Newport, we believe that provider enrollment is a critical part of the revenue cycle. As such, provider enrollment followup needs to be handled in the same way that accounts receivable (AR) follow-up is conducted. Follow-up needs to be standardized and systematic. The following Case Study provides an example of how Newport’s pro-active provider enrollment follow-up generated incremental revenue for a Newport client.

The Problem: Client was losing revenue due to not enrolling its Physician Assistants

  • Client was interested in generating additional revenue by enrolling their Physician Assistants
  • Client had 200 Physician Assistants which were not being billed as stand alone providers
  • Client looked at a number of internal and external provider enrollment options to process and manage the large provider enrollment initiative
  • Client had limited internal resources (staff and physical space) and wanted to start the project ASAP

The Solution: Client received a 10 to 1 ROI for Net New Providers

  • Newport initiated a comprehensive provider enrollment solution for all 200 Physician Assistants
    • Transition Kick Off Meeting
    • On-Site Documentation Collection
    • Built all Provider Profiles in our Credentialing System
    • Conducted Weekly Review of Missing Elements Document
    • Packaged Applications and Signature Packets
    • Distributed and Collected Signature Packets from Providers
    • Submitted all Applications (CAQH, Non-CAQH and Delegated)
    • Conducted Bi-Weekly Application Follow-up
    • Reviewed Advanced Reporting to Highlight Process Breakdowns and to Track and Trend all Outstanding Items
    • Conducted Weekly On-Site Account Management Meetings
  • Client was able to bill for Physician Assistants as an individual provider translating to substantial incremental revenue for the organization

 

About the Author

Scott T. Friesen is the CEO of Newport Credentialing Solutions and has over 12 years of healthcare experience in the hospital and faculty practice setting.

About Newport Credentialing Solutions

Newport Credentialing Solutions is the nation’s premier provider of cloud based software and IT enabled services dedicated to the credentialing life cycle. Newport provides cloud based workflow, analytics, and business intelligence credentialing software and IT enabled credentialing services to some of the largest academic medical centers, health systems, and multi-­‐‑ specialty group practices in the United States. Newport helps clients “Take Control” over their credentialing life cycle by streamlining operations, reducing credentialing related denials, and generating more cash for their organization.

For more information on Newport’s software and service solutions, please contact 516.593.1380 or info@newport.theadleaf.com.

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Newport Credentialing