The credentialing process is fraught with deadlines, paperwork and requirements that can leave your head spinning. Unfortunately, when it’s time to complete the process again to keep everything current, things aren’t necessarily that much easier. There are plenty of recredentialing mistakes that practices across the country face when it’s time to recredential.

Failure to Report Adverse Peer Review Actions

Most insurance companies require you to not only report these in your initial application but to also keep them up to date. Adverse peer review actions include things like revocation, suspension and voluntary relinquishment of clinical privileges, state licenses, DEA licenses or other memberships. While this can happen inadvertently, to third parties it can look a lot like you’re trying to hide something. More importantly, failure to report is a violation of the bylaws of your agreement and can ruin your relationship with a provider.

Starting Too Late

Recredentialing deadlines can sneak up on you, especially since many doctors fail to realize that recredentialing can take almost as long as the initial process. Set aside plenty of time to complete all forms, get all of the documents together and review licenses and certifications to ensure that they are in compliance. If you leave these steps until the last minute, your application might not be approved before the deadline, and you’ll need to start the entire initial credentialing process over again.

Missing Information

One of the most common recredentialing mistakes is also one of the easiest to prevent—missing information. Credentialing paperwork is not hard, but it is complicated. You need to take plenty of time to provide all required information in an accurate manner. If you are missing information, there is a high probability that the provider will not contact you to get it, meaning that your application will sit on the back burner for an indefinite period of time. Review your completed paperwork multiple times before you submit it.

Failing to Keep Up with Standards

Many credentialing processes require doctors at your practice to be registered with a number of federal health care programs including Medicare and Medicaid. All federal programs have different registration processes, and any errors in your registration could prevent you from a speedy recredentialing process.

Prevent Recredentialing Mistakes with Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.