The Invisible Impact of Credentialing – Part One

The past 8 to 10 years have been transformative in the “business” of providing healthcare.


The 2009 American Recovery and Reinvestment Act (aka ARRA, aka Stimulus Program) brought with it unprecedented incentives for healthcare providers to widely adopt electronic health records, and they did. One year later, the passage of the Affordable Care Act resulted in more than 20 million more Americans being covered by a health insurance plan or through Medicaid expansion.

These transformative events brought new considerations for maximizing operational excellence in the business of healthcare. One often overlooked consideration is the impact credentialing can have on the many aspects of healthcare operations. A well-managed credentialing program will have an impact on information technology, patient satisfaction, and revenue enhancement goals.

However, managing credentialing and provider enrollment can be a time-consuming and costly endeavor, especially when relying on antiquated methods such as paper or Excel spreadsheets for tracking. When managing the process in-house, inadequate staffing levels are often an obstacle to success. However, pairing the right credentialing and enrollment processes with powerful cloud-based tools, health systems can much more easily meet the demands of a quality-driven reimbursement model.

These blog posts are designed to bring awareness to the many invisible “touches” credentialing has in the healthcare setting. It also offers tips to consider when confronting the not so apparent implications of a credentialing program.

  1. Credentialing can disrupt your patient satisfaction outcomes.
  2. Make sure all data is protected – not just PHI.
  3. Prevent surprise medical billing.
  4. Consider overlooked costs.


Staff Writer

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