How To Stay Compliant With Quality Credentialing Services

Complying with healthcare regulations like HIPAA can improve patient safety, increase trust and confidence, and reduce legal and financial risks. Physician Practice Specialists has experienced consultants to help you comply with medical credentialing regulations. Our credentialing firm offers compliance training, practice startup consulting, contract negotiations, business technology integrations, and other services. Here’s how quality credentialing services can help you stay compliant:

Policy Development

Medical credentialing regulations require all healthcare providers in your organization to be credentialed. Working with experts can help you develop policies and procedures needed to verify the credentials of healthcare providers. Quality credentialing services also feature policy audits and updates to keep you on track with changing regulations. Involving experts frees you from the complexities involved in developing a credentialing procedure. Credentialing firms know what to include in the policy to make sure every healthcare provider stays compliant.

Team Training

Physician Practice Specialists can provide training for your credentialing staff to help them verify the credentials of all applicants. The credentialing experts audit all aspects of the applicant’s profile against the compliance requirements of relevant institutions in the field. Training helps every member of the credentialing staff to understand individual regulations and verification steps. Staff training also helps the credentialing team avoid errors and miscommunication using checklists, software systems, and other tools.

Records Management

Credentialing requires maintaining up-to-date information about candidates, applications, and providers. Working with an expert can help you maintain compliance by verifying every detail and double-checking data for accuracy. Credentialing partners can track compliance requirements, records, dates, and deadlines. Proper records management can expedite credentialing, saving you time and money. Credentialing firms also store files safely for easy access. Safe storage eliminates misplacements that can slow down the credentialing process.

Software Automation

Leading credentialing companies use technology to streamline the process and reduce non-compliance risk. Implementing software use in credentialing can reduce the time and resources required for manual credential verification. Automated software programs can prevent duplicates and conflicting data sets, providing a single reference point for accurate data and credentials. Software programs also support credentialing maintenance and simplify the verification process required for every credential renewal.

Regulations Tracking

Medical credentialing regulations vary depending on the applicant and state. Credentialing experts can help you track all the laws in your state. Standard regulations include HIPAA, which requires you to protect the privacy of patient health records. Medicare and Medicaid regulations require a medical license and malpractice insurance. Joint Commission standards require verifying education, certification, and licensure. Other requirements include state licensure, board certification, and national practitioner data bank reporting.

Expert Oversight

Credentialing is traditionally a complex manual process with multiple files, systems, and departments. Modern credentialing can benefit from software programs and automation but still involves various checks and verifications. Working with a credentialing expert can help you navigate common challenges like file misplacement, security threats, errors, and omissions. A credentialing company can provide the expert oversight required to maintain compliance and complete successful privileging and enrollment.

Seek Professional Credentialing Services

Physician Practice Specialists can help you reduce the time spent on paperwork, resulting in a quicker turnaround. Our credentialing experts also reduce the likelihood of errors and keep you compliant with the latest regulations. Since 2008, we’ve helped medical practices with credentialing, compliance training, technology integrations, contract negotiations, web design, and other services. Contact us today to learn more about our credentialing services and how we can help your practice.