The healthcare industry faces many challenges. The workforce shortage has been well documented, with staffing pressures mounting, and while scientific advances in genomics and other areas are ushering in an era of personalized medicine, these new therapies and diagnostics are costly, adding to rising healthcare expenses. In the middle of it all are healthcare providers and systems trying to balance demands while optimizing care and profits. As if medical services weren’t complex enough, providers must also deal with an abundance of administrative tasks. Medical credentialing falls into this category, depriving healthcare workers from focusing on what they do best. It’s therefore not surprising many are seeking medical credentialing solutions. And outsourcing medical credentialing services looks to be an effective one.
Outsourcing medical credentialing services to third parties isn’t necessarily new by any means. This strategy has been utilized by larger healthcare systems often to assist with administrative burdens. But increasingly, small provider offices and groups are realizing the value of these medical credentialing services. In part, this is because credentialing demands have become both more complex and frequent. And the risks involved ensuring that credentialing information is accurate and valid have similarly grown. As more providers come on board, they’re recognizing that outsourcing medical credentialing services offers a tremendous advantage. And as technology and systems have evolved to better support these services, the practice is becoming more routine. Though healthcare may be late to the game, they too are appreciating the benefits that outsourcing provide.
Medical Credentialing Demands
The process of medical credentialing is quite involved as one might imagine. It involves verifying that healthcare providers meet require qualifications for the positions they serve. This includes ensuring that they have the correct licenses and certifications as well as proven skills and completion of education requirements. Over time, the credentialing process has also become increasingly complex as well as more frequent. Healthcare facilities must have thorough medical credentialing procedures in place. And insurers also have a similar process before allowing a healthcare provider to bill for services. It is precisely these complexities that have forced healthcare stakeholders to devise medical credentialing solutions. And outsourcing medical credentialing services to third parties appears to be the best.
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In terms of medical credentialing demands, both individual providers and healthcare systems are on the hook. For individual healthcare providers, credentialing must be attained before income can be generated. Without medical credentialing approvals, clinics, hospitals, and insurers can’t let providers practice. At the same time, healthcare systems and organizations are ultimately responsible for validating credentialing accuracies. Failure to do so or to do this well places the organization at risk. As tighter regulations have been implemented, the process has become more time-consuming and highly detailed. Given the resources are limited in healthcare, the demand for medical credentialing solutions has grown. This is why many are turning to outsourcing medical credentialing services to accommodate these new pressures.
Benefits of Outsourcing Medical Credentialing Services
As one of the best medical credentialing solutions, outsourcing offers a number of advantages to providers. With advances in digital technologies and software systems, business process outsourcing (BPO) experts have developed high-level expertise. As such, they can utilize these systems to cut costs, save time, and reduce total credentialing delay times. This means that instead of taking 90-120 days for many medical credentialing tasks, a significant amount of time can be saved. And since time is money, this improves the bottom line. In fact, statistics show that outsourcing medical credentialing services can save between 20 and 80%. And by leaning on experts in the field, errors are significant reduced, which further speeds up the process.
While these are the more obvious reasons for outsourcing medical credentialing services, they’re not the only ones. These types of medical credentialing solutions help providers and healthcare organizations stay on top of regulatory changes. As a result, outsourcing credentialing provides greater risk management over time. Quality BPO providers also allow providers to scale their healthcare operations as they grow without difficulty. And most importantly, they save providers a tremendous amount of time in administrative processes. This reduces the opportunity costs associated with medical credentialing. And it allows providers to focus on care-related activities for which they are best trained. Because outsourcing medical credentialing services offers so many benefits, it’s clear why trends are shifting.
Embracing Medical Credentialing Solutions
According to researchers, outsourcing medical credentialing services is expected to grow significantly in the next few years. On average, these medical credentialing solutions is predicted to expand by 8-9% per year. By 2027, that means the healthcare BPO industry will exceed $12.9 billion with medical credentialing contributing to this. These predictions are supported by an expected rise in healthcare providers as well as rising regulatory complexities. Push will come to shove for many healthcare entities and force them to consider better strategies. Outsourcing medical credentialing services will be one of the more obvious ones given the many benefits it provides. Practices and hospitals will need to find ways to save on costs while making time for greater revenue generation. Shifting the responsibility of credentialing tasks to third parties will be a no-brainer as pressures mount.
While outsourcing medical credentialing services will be a rising priority for many healthcare providers, it’s not the only area. BPO services encompass many different areas for healthcare practices well beyond medical credentialing solutions. For example, providers may use quality outsourcing agencies for digital marketing, accounting services, call center support, and human resources. Revenue cycle management is another area that will become attractive as an outsourcing opportunity for healthcare entities as well. Claims processing, payment processing, and other front and back-office services may be better managed through outsourcing. The landscape for business process management has changed and will continue to move in an outsourcing direction. Once healthcare providers realize the potential such strategies offer, they’ll embrace BPO services wholeheartedly. That trend has already begun with medical credentialing leading the way.
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