Activate a denials prevention mindset with strong credentialing
Decreasing denials is a top priority for revenue cycle teams. Denials – and ultimately lost revenue – can result from missteps in the credentialing process. While detailed and labor-intensive, an effective credentialing process is key to addressing this challenge. Organizations that prioritize the credentialing process are positioned to move from a mindset of denials management to denials prevention.
Netsmart supports our clients in their effort to decrease denials and increase reimbursement by providing credentialing services. This revenue cycle management service helps streamline the provider onboarding process, organizes the collection of documentation, and takes a proactive approach to managing the details of credentialing.
Credentialing and provider enrollment to fit your needs
Individual provider enrollment
Payer panel enrollment/maintenance
Provider maintenance
Backlog cleanup
Full credentialing outsource
Privileging
How Netsmart RCM credentialing services can help
Payer panel enrollment/maintenance
- Maintain master roster by payer
- Update roster as clinicians onboard/offboard
- Notify payer of roster changes as applicable
- Reconcile with payer at regular interval
Provider maintenance
- Complete CAQH attestations every 120 days
- Medicare/Medicaid revalidation management
- Enrollment updates (demographic update, licensure change, pay-to address update, service location updates, etc.)
Experts in credentialing
The credentialing process gets increasingly more complex for organizations that operate in multiple states and have numerous payers. For every organization - but especially growing organizations - it's critical to understand the root cause of credentialing-related denials. If you're looking to improve your credentialing process or gain more insight to help identify and manage the root causes of credentialing-related denials, Netsmart RCM experts can help. We can assist with specific elements of credentialing or take over the entire credentialing function - whatever works best for your organization.
In this 4 minute clip, a Netsmart RCM expert outlines the 3 root causes that we see for credentialing. Listen in as she shares strategies for preventing and managing those credentialing challenges.
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Tackle denials with a proactive credentialing processTalk to an Expert