Delegated Credentialing: Pros and Cons

Angus Roberts
In today’s fast-paced healthcare environment, the concept of delegated credentialing has emerged as a potential solution to streamline the credentialing process for healthcare providers. This innovative approach offers various advantages, but it also comes with its share of drawbacks. Our article, “Delegated Credentialing: Pros and Cons,” delves into the details of this system, offering valuable insights to help you make an informed decision.

Healthcare provider credentialing is an essential process that improves the quality of services, builds patient trust, reduces medical negligence claims, boosts reputation, and much more. Without medical credentialing, practices and clinics could stay behind the competition.

Since medical credentialing is a time-consuming process, it could lead to delayed health system enrollment, frustrated practitioners, inefficient member access to healthcare providers, and much more. That’s why many clinics prefer to delegate credentialing to authorized companies.

Qualified Credentials Verification Organizations (CVOs) can reduce the time it takes to verify healthcare provider credentials and ensure timely re-credentialing without causing downtime.

Let’s take a closer look at the pros and cons of delegating the credentialing process.

What is Delegated Credentialing?

Delegated credentialing involves outsourcing medical credentialing to a third-party credentialing service provider.

When you take advantage of delegated credentialing, you don’t just outsource credential verification. The third party can be responsible for evaluating the qualifications of healthcare providers and making credentialing decisions.

Advantages of delegated credentialing

Delegated credentialing can be highly beneficial for healthcare facilities of all sizes. The main benefits of outsourcing this process include:

Time Savings

A qualified CVO takes a proactive approach to credentialing. By doing that, they can cut the credentialing time by several weeks.

Besides speeding up onboarding and improving retention, a faster credentialing process allows your practice to focus on providing quality patient care and streamlining other revenue-generating activities.

Since CVOs have substantial experience and access to a variety of credentialing resources, they easily speed up the process while taking the burden off your HR team’s shoulders.

Accuracy

When it comes to medical credentialing, accuracy plays a major role. Mistakes in applications, improperly prepared documents, and missed filing deadlines delay credentialing and cause downtime.

When a qualified organization handles medical credentialing, they use its experience to minimize errors and maximize efficiency. By guiding your organization through the credentialing process, they ensure higher accuracy and reduce unexpected downtime and expenses for your healthcare providers.

Improved Recruitment

Faster and more accurate medical credentialing can improve the recruitment process. Besides making your organization more appealing to healthcare providers, it increases your choice of candidates.

Healthcare providers are more willing to work with clinics and practices that improve the credentialing process. They are much more likely to choose an organization that doesn’t spend half a year verifying credentials.

Lower Costs

Arranging credentialing on your own increases the cost of the process. You need to designate HR team members who have to spend time handling credentialing. By arranging CVO credentialing, you are reducing labor costs and minimizing administrative expenses.

Meanwhile, faster credentialing allows your healthcare providers to begin working quicker, thus contributing to your practice’s bottom line.

Disadvantages of Delegated Credentialing

While delegated credentialing is a time- and cost-effective decision for many organizations, it comes with several downsides.

  • Accessibility – to ensure high-quality credentialing that saves time and money, you need to find a reliable service provider. These providers may not be readily available since qualified organizations are often overwhelmed with requests.
  • Lack of control – some healthcare organizations may worry about the lack of control they have over credentialing after delegating the process to a third party. This issue can be solved by choosing a reliable service provider.
  • Miscommunication – medical credentialing involves the close collaboration of the healthcare organization, healthcare provider, and the credential verification company. If not arranged properly, communication issues may arise. This could delay credentialing and cause downtime for healthcare providers.
  • Compliance – if the credential verification service fails to comply with the credentialing regulations, the healthcare organization remains liable for mistakes.

The majority of issues that may arise when you delegate medical credentialing to a third party usually have to do with the wrong choice of organization.

By choosing a reliable service provider and maintaining clear channels of communication, you can reap all the benefits of third-party credentialing without facing the cons.

Is Delegated Credentialing Right For Your Organization?

Outsourcing medical credentialing is an excellent way to save time and money for your organization while reducing the chances of errors and preventing healthcare provider downtime.

Clinics, practices, and facilities of all sizes choose to delegate medical credentialing in order to speed up the recruitment process, expand their healthcare provider network, and provide better services to their patients.

Organizations that prefer to handle medical credentialing on their own usually have large HR departments and sufficient resources to do it.

The key to taking full advantage of outsourced medical credentialing is collaborating with a reliable organization. If the service provider is qualified, you can streamline the credentialing process while improving your organization’s productivity.

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