5 Common Mistakes in Medical Credentialing (and what you can do to avoid them!)
Credentialing errors in hospitals can be frustrating and costly for providers and healthcare facilities, causing significant onboarding delays.
Just imagine the frustration of recruiting a top-notch provider for a critical role at your facility, only to have their start delayed due to a credentialing error.
Data show financial loss -
Extended credentialing timelines and delays can cost a medical group over $1.8 million in lost revenue per provider. https://www.beckershospitalreview.com/finance/reclaiming-revenue-a-found-money-trifecta-in-credentialing-privileging-and-enrollment.html
Lost revenue at $7,500 a day when a physician is unable to practice due to credentialing delay
5 Common Mistakes in Medical Credentialing
Inadequate primary source verification -- types of credentialing in healthcare - Facility credentialing and payer credentialing
Poor documentation and record-keeping - lack of data integrity
Inconsistent ongoing monitoring
Failure to address red flags
Insufficient communication and collaboration ( practitioner credentialing process, hospital credentialing process)
Effects of Poor Physician Credentialing and Privileging
If these common credentialing mistakes occur, it can lead to various negative consequences and risks.
Patient Safety and Quality of Care:
Providers compromise patient safety with fraudulent credentials or unresolved issues.
Increased risk of errors and inaccuracies in patient records, impacting care quality.
Potential patient harm due to hiring providers with substandard qualifications or a malpractice history.
Legal and Regulatory Consequences:
Legal and regulatory implications due to hiring providers with invalid or expired licenses, certifications, or qualifications.
Penalties, sanctions, or loss of accreditation resulting from non-compliance with regulatory requirements.
Repetitional Damage and Trust:
Reputational harm to the healthcare organisation or medical office if improper verification is discovered.
Loss of trust within the community due to compromised credentialing practices.
Difficulty in attracting and retaining qualified providers due to a tarnished reputation.
Operational Efficiency and Financial Implications:
Delays in patient care coordination and continuity due to breakdowns in communication between stakeholders. (credentialing requirements for physicians, medical staff privileges)
Financial implications from legal proceedings, penalties, or loss of service reimbursement.
Decreased efficiency and productivity necessitating remediation and corrective actions, leading to additional costs.
Liability Risks and Patient Confidence:
Increased liability risks for the organisation in cases of malpractice or patient harm caused by providers with red flags or substandard care.
Erosion of patient trust and confidence in the healthcare organisation or medical office.
If overwhelmed with the process- don’t hesitate to ask for help. HTS provides medical staff professionals to help with your requirements.