Thought Leadership

New Perspectives To Improve the Credentialing Industry

Q&A: Is Your Provider Enrollment Software Keeping Up With the Rapidly Evolving Credentialing Landscape?

David Meier, Newport VP of Technology Solutions, discusses ways to ensure that your provider enrollment software is meeting all of your operational and reporting requirements.

 
Q. How do you identify if your provider enrollment software is keeping up with the changing times?

A. One area to look at is workflow software. A couple of questions to ask include:

1. Does your provider enrollment software enable you to manage your provider’s credentialing life cycle using workflow tools that make the enrollment process easier, rather than more difficult?

2. Do your software have advanced workflow and reminder systems that stratify your activities based on gross charges linked to your “in-process” applications?

3. Does your software keep track of all follow up notes in an easy to document and report on module?

4. Is your reporting tool easy to use? Do you have click, drag, and drop reporting?

Another area to look at is productivity. Using your current provider enrollment software, are you able to ensure that your staff are staying on top of their daily tasks in an easy to track and trend manner? Further, are you able to easily report on your staff’s productivity to ensure that they are taking the correct actions and in the appropriate time?

 
Q. What is the impact of having a provider enrollment software tool that is agile enough to meet the changing provider enrollment requirements?

A. There are many benefits that come from having an agile provider enrollment software, but here are three:

1. Increased Revenue – When your software can link gross charges to your “in-process” applications, you can stratify your activities to ensure that you are working those providers with the highest number of charges first, and then work those providers with a lower amount of charges second.

2. Increased Productivity – When your software enables you to work your provider’s credentialing life cycle by “task” (meaning data entry, application processing, follow up, and PIN entry), you gain increased productivity (meaning specialization of task) and increased staff stability (meaning you can more easily hire staff who specialize in data entry than understand the entire credentialing life cycle).

3. Increased Performance Through Reporting – When your software enables you to easily track and report on each step of the credentialing life cycle, you are able to establish performance baselines from which you can improve overall performance.

 

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