A properly credentialed practice along with its providers seeking participation status with various payers is critical to the RCM process. Few things can negatively affect provider revenues greater than credentialing being out of order. Credentialing is a foundational element of the RCM process; all reimbursement depends on it. The credentialing process needs to be managed for each individual provider with each individual payer. For medical practices, it also needs to consider hospital payer relationships and other group contracts like PHO’s. Credentialing is a never-ending process and needs to be continuously monitored and updated. The credentialing process also considers specialty specific credentials of a provider, enabling reimbursement for specialized procedures. CRS offers credentialing services as a stand alone service or as an integrated part or our broader RCM services.
Since the credentialing process needs to be managed for each provider and with each payer, a credentialing specialist needs to be organized and knowledgeable about relevant contracts. To help you meet the never-ending challenge of monitoring and updating, CRS offers expert credentialing services—either as a standalone option or part of an integrated RCM service package.
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