Affordable Insurance Credentialing Services-Cost Efficiency

September 17, 2019 Insurance Credentialing

Given the lengthy, tedious nature of Insurance Credentialing Services, the question that most physicians and medical practitioners are left with is if there is such a thing as affordable Insurance Credentialing. Typically, the cost of credentialing with insurance companies is directly related to the time that physicians spend in the process.

The typical duration of the entire process is around four months. During these four months, the medical practice has to go through a variety of steps to get the credentialing process right. Frankly, it varies according to various factors.

Physician Credentialing Services Cost may vary based on:

• Current Credentialing Service
• The number of physicians needed to be added
• How quickly you grow your practice
• Changes in insurance contracts
• Additional services rendered by the credentialing service provider

So coming back to the original question – how much does it cost to get credentialed with insurance companies? That answer will vary from physician to physician, based on how much time they spent on the process. To get some clarity on provider credentialing services cost, we must first understand why the process takes so long to conclude.

Why is the Insurance Credentialing Process So Long?

Thanks to credentialing, any newly hired health professional cannot start work at their new facility for the initial few weeks to six months. Normally, it shouldn’t take providers more than 3 hours as all they have to do is gather all necessary documents and submit them.

For the facility staff, however, this process can be excruciatingly long. They are responsible for executing several crucial tasks, which include:

• Launching a Background Check
• Gathering and reviewing the health professional’s credentials, past reputation, and case history.
• Reviewing claims, board history, and privileging
• Check sanctions with OIG (Office of Inspector General)
• Perform primary source verifications such as medical boards, education history, etc.
• Present files to facility stakeholders, credentialing, and executive committees.

The process has to be repeated every time a new provider is to be credentialed. This makes insurance credentialing extremely frustrating. Communication is often a problem during the execution of these processes and the fact that each facility has its own way of spearheading the credentialing process, makes it even more challenging.

Other factors, like incorrect or missing information in the application, can delay the process even further. If the credentialing board has a stuffed schedule, then you can expect further delays. As such, you can now understand why many health professionals and institutions consider credentialing to be a never-ending headache.

How Much Does Credentialing Cost?

One way to estimate Insurance Credentialing Services costs is by calculating the time a physician would spend on the actual credentialing process. On average, that would be 43 minutes per day.

Now, if we assume that a physician works on $100/hr, that’s approximately $20000/year in credentialing work per physician. This is excluding any paperwork; of course, you lose more money if you lose relevant documents.

In hindsight, you are spending way more than $20000/year. Medical Insurance Credentialing costs way less when outsourced to a third party like DENmaar. Refer to the below breakdown to understand – how much does physician credentialing costs?

Credentialing Cost Breakdown

Individual Physician Cost – 100-200$ per physician

CAQH Database

Initial Setup Costs can go up to $200-$500

Panel Application Cost

Physicians should expect to pay $100 per panel

So, the average cost to credential a physician is somewhere between $2000-$3000/per year. The average cost to credential a nurse practitioner will be more or less the same as well.

Why does Credentialing Cost So Much?

Most of the cost incurred in the process of credentialing is because of its lengthy nature. You lose money if you lose your documents. You lose money if you fail to follow up with the insurance companies, resulting in the expiration of your application. The entire process has too many pot-holes for medical practices to crash and burn.

An average physician can lose thousands in income due to this process. Let’s say that a physician makes $299,000. Waiting to render their services for a few weeks due to credentialing will cost them around $25000. Even worse, waiting for six months could cost them an income of around $150,000.

The problem isn’t limited to a few healthcare professionals. In fact, the entire healthcare industry loses billions every year in the USA due to an inept credentialing process. Fortunately, there is a way to avert this disaster and make the credentialing process more cost-effective.

Perform Credentialing in a Better way with DENmaar

Credentialing doesn’t have to be as time-consuming or costly as it has been for a long time. All you need are the right credentialing experts shouldering the responsibility on your behalf. This is where DENmaar’s insurance credentialing services come into play.

DENmaar is home to the credentialing experts, resources, and insight needed to expedite and execute the entire credentialing process in an effective and efficient manner.

DENmaar offers a fully automated system that provides practitioners with end-to-end solutions to credentialing. You are automatically updated about the status of your application. You get automated re-validation alerts, are assisted throughout the CAQH form filling process, and are alerted of your status application in real-time.

Affordable medical Insurance Credentialing Services cost is possible only when you outsource them to companies like DENmaar.

Fill out the form below or call now on 1-888-595-5100 to get a free estimate.