Pros And Cons Of Outsourcing Credentialing Services

As a private practice, any time you sign a new payor contract or bring on additional practice professionals, you must ensure the people providing services and performing treatments are credentialed correctly with your payors.

Unfortunately, many small to medium-sized practices lack the robust onboarding systems and procedures to accurately credential new team members every time, leading to a series of issues with obtaining reimbursement from payors. This in turn affects revenue, which makes credentialing vital to the health of your practice and revenue cycle.

But is it worth outsourcing to a team that doesn’t work in your office? Let’s explore the pros and cons of outsourcing credentialing services as part of revenue cycle management.

Cons of Outsourced Credentialing

The most obvious downside to having a third party handle your credentialing services is the loss of control over the process. Practice managers and leaders no longer handle every step of the onboarding and reimbursement process, and some credentialing service companies don’t provide frequent or transparent reports on how they’re handling the process. This takes critical information about the financial health of the practice away from decision-makers, which can cause unintentional negative side effects.

When partnering with an external credentialing service firm, you also have to turn over a lot of data on a regular basis. Make sure the company has secure file transfer protocols and tools and is able to fully comply with HIPAA regulations to ensure your data isn’t compromised or misused.

Another potential pitfall is letting a partner over-charge over the years they contract with you little by little until you end up paying more than you do having an in-house employee or team handle your credentialing. Follow up on a yearly basis to evaluate whether outsourcing is still a profitable choice for your practice.

Benefits of Outsourcing Medical Credentialing Services

To reap the full benefits of outsourced credentialing, make sure to partner with a well-qualified and experienced team like PayrHealth. This ensures your practice doesn’t get under-served and that the people who need to be credentialed are taken care of in a timely manner so no revenue gets denied due to errors or gaps in the credentialing process.

The main benefit is the cost savings of having an outsourced provider rather than an in-house team that requires training, salaries, and benefits. By outsourcing this complicated process, you free your team to focus on what’s most important to them: providing the best patient care possible.

Many private practices operate with a lean team that can be hard to find quality replacements if an office assistant or manager leaves or is terminated. In emergencies when you simply need a team to handle credentialing as a stop gap measure, outsourcing provides a simple way to get up and running with new providers until you can hire an in-house team member again.

In addition, PayrHealth can act as an extension of your team when they’re just a little overwhelmed with the administrative burden of credentialing.

Experienced Credentialing Services by PayrHealth

Save time and money while ensuring your revenue flows aren’t interrupted when new providers join your team with Revenue Cycle Management services from PayrHealth. Our team has worked in all 50 states and understands the complexity of the payor-practice relationship, including the importance of timely, accurate credentialing. Find out how we can help your practice reduce expenses and free up your staff’s time by calling or contacting us online today.