Proper Credentialing = Better Revenue Flow & Liability Protection

Terri Lynn Davis is the Credentialing Director at 1st Assistant Credentialing Services where she provides nationwide credentialing services for a wide variety of healthcare providers, suppliers, and facilities with numerous specialties. She has over 15 years of experience working in the medical credentialing sector which includes both payor enrollment and primary source verification. She holds a Bachelor’s degree in Healthcare Administration with a minor in Business Management from Western Kentucky University and is passionate about sharing her knowledge and experience with credentialing staff across the country.

Terri Lynn joins me today to discuss the credentialing process and why it’s an important part of your revenue cycle. She explains why she recommends outsourcing the credentialing process instead of managing it internally, how provider credentials impact your practice's ability to get paid for patient services through the insurance companies, and the best practices for maintaining insurance enrollments when internally managing the credentialing process. She also explains the difference between the initial credentialing process and the process of re-credentialing, tools and resources you can use to monitor and manage the Medicare re-credentialing process, and why it’s crucial for your billing and credentialing departments to communicate and collaborate with each other.

“If you’re not credentialed and contracted and you’re seeing patients, you’re at risk for no payment for those services, or it becoming the patient’s responsibility - Terri Lynn Davis

This week on PAHCOM:

• What ‘credentialing’ is in the medical field and why it’s an important and necessary part of your revenue cycle
• Why providers should consider outsourcing the credentialing process
• How provider credentials impact your office’s ability to get paid by an insurance company for services provided to a patient
• What you need to know to stay credentialed, even when information changes throughout the year
• Best practices for maintaining insurance enrollments when managing the credentialing process in-house
• The difference between the initial credentialing process and re-credentialing
• Why it’s crucial for the credentialing and billing departments to communicate and collaborate with each other
• How 1st Assistant Credentialing Services benefits medical practices across the country

Resources:

• PECOS Online Portal
• CAQH

Connect with Terri Lynn Davis:

• 1st Assistant Credentialing Services
• Phone: [phone]
• Email: [e-mail]
• 1st Assistant Credentialing Services on Facebook
• 1st Assistant Credentialing Services on Twitter
• 1st Assistant Credentialing Services on LinkedIn

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Thanks for tuning into this week’s episode of the PAHCOM Podcast, the medical management radio show for the solo provider and small group physician practice. If you enjoyed this episode,