To pave the way and have better chances in the credentialing process, one must evade making common mistakes. Payor enrollment is the request made to the insurance company from the provider side to enroll in the network so as to join a health insurance plan network. But the majority don’t succeed in this because this is not something done very often so mistakes are inevitable.
Here are some common areas that one must look upon before sending to an insurer.
Know your forms and plans
Providing accurate information is important. To achieve this avoiding mistakes is essential. The foremost and substantial need is to find the right form to be filled out. The provider type form consists of confusing numbers which serve as the first step for denials. So, it is important to have a distinctive knowledge of forms and have clear ideas on plans.
Be aware of your writing
Next is to keep an eye out for details, accurate information is the key to acceptance. These can be some common details about yourself that might be of the utmost importance. A change of spelling can also deny your application. These details, even including your unique details like signature changes in one place, can make the reviewing process complex. Double checking is the only way to avoid these inevitable mistakes. So make the task simple, and don't make them overlook it.
Prove your authenticity
Be ready to provide your supportive documents of the information given. The underlying documents that you’re going to submit in support of your details should be accurate. Submitting an expired document is not going to help you in making your statement right, so be aware that your documents are valid in their current state.
Clarify their doubts immediately
Find yourself some time to answer the questions that might come to you with your application. Always be ready to answer. During the review process, make sure you’re always available and responsive. Your quick clarifications will make the process quick. The prolonged process of verification of your details may require some clarifications from your side this is where you should answer.
Revise your details then and there
Updating is another key criteria to consider here. CAQH (The Council for Affordable Quality Healthcare) serves as a giant database that is used by the majority of insurers helps in providing our data to a wide range of insurance parties and enhances the chance of credentialing. It is also important to be precise in this platform, thus we might need changes to make about ourselves, our qualifications, and our working status
Have prior talks to ensure your expected time
Have clear communication with the payer about the expected time period. It might take months. So be patient and at the same time know and have contacts with your payor to have a clear understanding of your enrollment.
Final thoughts
So it’s all about yourself that needs to be checked before submitting. Being an essential factor for providers, payor enrollment is also complex for most due to the number of denials faced by many. But avoiding these common mistakes will make your application alive.
Practolytics can help you with your credentialing process through streamlined services and a team of professionals who are always up for delivering the best. Learn more about Practolytics healthcare credentialing.
