Providers and health care systems lose an average of $30K+ for a single primary care provider every month when there is a delay in provider enrollment. For specialty care, the losses are even more staggering.

Enrolling a single provider manually in a health plan can take anywhere 1 to 3 months. During that time, you lose revenue, and patients could go elsewhere or worst they lose the critical time when they need care. Physicians can see patients faster, get paid for patient care, and decrease the percentage of claims denied when technology-enabled provider enrollment processes replace cumbersome manual efforts. It results in increased revenues through faster reimbursements. And more importantly quicker services to the patient, especially when in some cases there are wait period for patient to get services.

“Current industry challenge is not with digital contracting or credential verification alone; it is with the end-end provider enrollment process.

Costly Impacts of Healthcare Credentialing Delays

Credentialing is critical for hospitals and health systems, as it validates a provider’s qualifications, board certifications, work history and references.

The term usually comprises two separate processes. One, called privileging, involves approving an individual provider to perform a specific procedure or specific set of privileges. The other, provider enrollment, ensures providers are enrolled with all their organization’s insurance plans, so they receive correct payment.

The credentialing process is a major hurdle for hospitals, ambulatory surgery centers and physician offices. The process can cause significant delays in getting new clinical staff onboard and reimbursed for the services rendered.

“More Than Two-Thirds of Credentialing Processes Take 5-6 Weeks to Get a Clinician Up and Running”

A recent study by SkillSurvey shows, the traditional credentialing process is outdated and slow. While waiting to be fully credentialed, top medical talent sits on the bench, negatively affecting the hospital revenue cycle,”.

• 62% of respondents said it takes from one to three weeks for peer references to respond to traditional credentialing requests
• 50% of respondents report that it takes one to two weeks to verify a hospital affiliation
• Nine in ten organizations believe it is critical to continue improving the applicant onboarding experience within the credentialing process

Our flagship product ConCred is built-in with a provider enrollment module, which makes this scenario easier by minimizing the time for provider enrollment by automating the internal diligence check and validation procedure before the application is sent to payors. “ConCred,” an integrated connected payer enrollment and credentialing system. Our integrated contracting and credentialing, a unified solution for credentialing and provider enrollment, streamlines the onboarding process, saves you time, and optimizes your revenue cycle. Enroll your Providers using automated, workflow-driven software that expedites both access to health plan members and revenue.

Features

• An enterprise-wide cloud-based technology platform
• Centralized Data and Document Storage
• Smarter Privileging
• Cross Team Communication for Provider Enrollment
• Compliance rules engine
• Streamlined Operations

 

Minimize Denials. Recover Valuable Time.

Our provider enrollment module in ConCred reduces the time it takes to enroll providers with payers. One integrated solution that automates contracting, credentialing, and provider enrollment processes to streamline onboarding, reduces time, and helps you optimize the revenue cycle. Cross-functional capabilities of ConCred includes business process unification, automation, and single-platform delivery. It is easily integrated with other solution components of the Payor/provider applications and e-delivery channels, streamline processes, improve operational efficiencies, and cost-effectively deliver a superior customer experience. Solution enablement fits any space in the identified verticals below who face issues with revenue enablement, decision making, forecasting, and contracting and credentialing capabilities resulting in reduced customer and service costs, improved revenues, and enhanced customer experience.

 

The ConCred Advantage

Communicates with all players involved in the organization

A single platform that connects HR, RCM, Finance, Payor Relations, Operations and Providers.

Easy to Use

A simple, web-based enrollment process that new users can learn in minutes and simplifies payer-provider communication.

Builds up to greater efficiencies over time

Today, most payers are yet to change their technology systems to a more efficient provider enrollments process. An automated enrollment service saves providers the hassle of dealing with individual and manual documents collections, compliance check and form filling. As more providers adopt this approach, payers have a greater incentive to upgrade their technology.

List all payers and common electronic enrollment types

ConCred maintains an updated database of all provider information, enrollment form library, and payer procedures. You can enroll a provider through auto filled enrollment PDF forms or through custom rosters based on payor’s ask.

User-friendly web-based forms

ConCred works closely with providers to develop a solution that solves their business challenges. Our portal should feature intuitive design, easy-to-understand data fields, picklists, and automatic error detection. Filling out forms should be faster and error-free. New provider enrollments and changes to provider enrollment information should take just a few clicks.

Improved payer provider relationships.

Cutting down frustrating, manual work for providers and payers frees up time on both sides. With fewer follow-up calls and requests to re-submit information, provider-payer relationships become more effortless.

To schedule a quick demo of ConCred, do write to contact@humanebits.com