Efficient processes are everything in healthcare. The credentialing process is one of those tasks when done right, guarantees smooth operations and revenue flow. It can be a monumental hassle for any practice trying to manage it in-house.
The question that many practices find themselves wondering is: How much do credentialing services cost? We’ve got you covered with all the insights you need at Dynamic Revenue Cycle. This guide includes a detailed breakdown of costs, time, and why outsourcing can be the smartest move for your practice.
The True Cost of Credentialing Services
Credentialing services are an important investment for healthcare practices. When properly managed, they safeguard your revenue, protect your reputation, and prevent legal and financial setbacks. However, managing this process internally can drain resources. Many practices don’t realize they’re spending far more than they anticipate.
Take a look at this scenario: An in-house credentialing specialist earns an average salary of $43,558 per year. This excludes office space, software, and training, retention, and onboarding hours. Now, multiply that by the number of providers you need to be credentialed and it adds up fast. Then there’s the unseen cost – the lost revenue from processing delays, errors, and compliance issues. Suddenly, that in-house team doesn’t seem so economical.
On the other hand, when you outsource credentialing services, it offers cost savings and peace of mind. You’re paying experts who specialize in handling credentialing quickly and accurately.
What Is Credentialing in Healthcare?
Credentialing is the process that verifies a healthcare provider’s qualifications, from education to board certifications, insurance coverage, and more. This is a legal necessity and every step must be followed with precision. This ranges from primary source verification to make sure that providers can legally bill insurance companies. Otherwise, you risk hefty fines, denied claims, and even suspension of privileges.
Credentialing doesn’t stop once a provider is verified. Recredentialing cycles are also necessary to keep credentials up to date. In healthcare, every insurance provider, facility, and governing body has its own requirements. These moving parts can lead to endless headaches if managed without professional help.
The Financial Impact of Doing It In-House
If you’ve ever found yourself in the midst of credentialing tasks, from gathering provider documentation to dealing with insurance panel applications, you know it’s a money pit. Credentialing a single physician costs about $20,000 annually when handled internally.
This figure covers everything from staff salaries to administrative overhead and follow-up work. These are hours that could be better spent on patient care. Instead, you’re managing paperwork and tracking down insurance panels.
Imagine running a growing practice where you might need to credential multiple providers, each with its own set of payers and facilities. That’s thousands more in administrative costs, not to mention the inevitable errors that occur when in-house teams are stretched too thin. An incomplete or inaccurate submission could cost even more, whether it’s resubmission fees, legal penalties, or lost revenue from uncredentialed services.
The financial toll of in-house credentialing can also sneak up in hidden ways. Mismanagement can lead to delays in billing or denied claims. Every day without proper credentialing means lost revenue. Hence, it’s an increasingly risky strategy for practices that want to grow.
Why Outsourcing Credentialing Solutions Is the Best Option
Outsourcing can be a great option when it comes to credentialing solutions. While your in-house team is juggling multiple responsibilities, a credentialing provider’s sole focus is on getting your providers credentialed swiftly and accurately.
This specialization is invaluable because credentialing is a process that leaves no room for errors. Outsourced teams have the expertise to tackle credentialing roadblocks that could otherwise cost you time and revenue.
Moreover, outsourcing credentialing services removes the burden of managing countless payer and facility requirements. You won’t need to worry about changing regulations, re-credentialing cycles, or keeping up with insurance contract updates. Our team at Dynamic Revenue Cycle takes care of the entire process from start to finish so that your team can focus on the core function of your practice.
Outsourced credentialing solutions reduce your financial and administrative load and significantly speed up the credentialing process. While manual credentialing can take upwards of 180 days, outsourced providers can cut that timeline dramatically, sometimes even in half. Our medical credentialing services help you get reimbursed faster and avoid the pitfalls of missed deadlines or incomplete applications.
Breaking Down the Cost of Outsourcing
On average, expect to pay between $2,000 to $3,000 per provider annually for full credentialing services. The total cost can fluctuate based on the number of providers, the current credentialing status of your practice, and how quickly your practice is growing.
This price might include everything from initial credentialing to re-credentialing, managing payer enrollments, and database management services like CAQH ProView. Some credentialing providers may also offer advanced services such as healthcare consulting services to help optimize your practice’s operational efficiency beyond credentialing.
It’s important to remember that while outsourcing does come with its own costs, these pale in comparison to the financial burden of managing the process internally. When you factor in the time and revenue saved by having a specialist handle your credentialing, it’s clear that outsourcing offers far better value.
The Long-Term Value of Outsourcing Credentialing Solutions
When considering the true value of outsourcing credentialing solutions, it’s important to look beyond just the immediate cost savings. Credentialing is an ongoing process that requires constant attention, updates, and compliance checks.
A third-party credentialing service keeps your practice ahead of these requirements. We can do so by consistently managing re-credentialing, monitoring payer updates, and ensuring timely renewals. This proactive approach saves you from unexpected delays that could freeze revenue streams.
Furthermore, outsourcing improves the accuracy and efficiency of your credentialing process. It reduces the risk of costly errors. Credentialing mistakes can result in denied claims, financial penalties, and even exclusion from payer networks, which can put your practice’s reputation and revenue at risk.
In the long term, outsourcing guarantees that your practice remains compliant and financially stable. It lets you focus on providing patient care. With us, you can trust that your credentialing process is in capable hands.
Avoiding the Hidden Pitfalls of Credentialing Delays
Every day your provider isn’t credentialed is a day you’re not getting paid for their services. A manual, in-house credentialing process can take as long as 180 days. That’s half a year of missed revenue opportunities, which is simply unsustainable for most practices.
Outsourcing speeds up this process dramatically. With our services, providers can often be credentialed up to three weeks faster than with traditional methods. That means more providers seeing more patients and more revenue flowing into your practice sooner. In an industry where efficiency is everything, speed matters.
The credentialing process is complicated and costly, especially when handled internally. With Dynamic Revenue Cycle, we offer a cost-effective way to manage this task. Our team is skilled at handling the full spectrum of credentialing services, from initial setup to ongoing maintenance so that your practice stays compliant and financially healthy.
Outsourcing our credentialing solutions allows you to free up your staff’s time, reduce costly errors, and see faster turnaround times for your provider enrollments. When you think about the cost of handling it yourself, you’ll see that outsourcing is a no-brainer.
Hand over the tedious credentialing process to our experts at Dynamic Revenue Cycle. Contact us today to learn how we can ease your credentialing process and help your practice thrive.