Problems Faced By Payor Enrollment Essay

1459 Words Aug 1st, 2016 6 Pages
Payor enrollment has become increasingly complex. Changes in reimbursement, narrow and closed networks, and risk-based contracts have created a new landscape which has left many healthcare organizations scratching their heads for answers. For a small healthcare organization, running the credentialing and enrollment process in-house is a manageable endeavor. However, for larger groups such as MSOs, DMEs, hospitals, regional or state practices, clinics and health systems, especially those with multiple locations, it can be a time-consuming and costly venture. This is especially true when relying on manual methods like paper documentation and email calendar alerts to run credentialing in-house.

Healthcare organizations exist to address the healthcare needs of their patients. In their most basic form, they help sick people get better. The reality is that in order to remain viable as an organization and continue to help these people, you must receive timely payment for services rendered. This means working with various payors including Medicaid and Medicare.

Credentialing, enrollment and contracting needs are common pain points in the critical effort of receiving payments for the healthcare services provided. In this whitepaper we’ll address why outsourcing these frustrating and time-consuming tasks makes financial sense. To help you find a partner to best fit your needs, consider the following:

1. Experience matters – A credentialing service provider (a partner) that is…

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