When it comes to the success of a physical therapy clinic, one important aspect that often goes overlooked is the credentialing process for new hires. Credentialing is the process by which healthcare providers are vetted by insurance companies to ensure that they are qualified to provide services to patients. In order to ensure that your clinic is running smoothly and that your patients are receiving the best care possible, it's essential that you have a thorough and well-organized process for credentialing new hires.
Here are a few key steps to follow when credentialing new hires:
Create and utilize comprehensive new hire credentialing documents. This should include specific payor materials, CAQH information, and education and training records.
Submit credentialing payor applications to payors. This should include all of the necessary documentation and information to ensure that your new hire is approved as quickly as possible.
Have a clear process for keeping track of payor applications, submission IDs, reference numbers, etc. This will help ensure that you don't miss any important deadlines or lose track of important information.
Set follow-up guidelines for each payor. Ask the payor for their expectations and make sure that you are meeting them.
Have clear guidelines for your cosignature process or claim hold process. All team members need to be aligned on this, including scheduling, intake, verifications, therapists, and billers.
Have a process for communication with the billing team as approvals come in. This will help ensure that your billing process is running smoothly and that you are getting paid for the services that you are providing.
Have a process to recredential and reattest CAQH profiles. This will ensure that your clinic is always in compliance with the latest regulations and that your patients are receiving the best care possible.
By following these steps, you can ensure that your new hires are credentialed quickly and efficiently, and that your clinic is running smoothly. With the right processes in place, you can focus on providing the best care possible to your patients, without worrying about the administrative side of things.