4 Strategies for Streamlining the Medical Credentialing Process:

To expedite the medical credentialing process, consider implementing the following steps:

1. Expand Your References (Preferably to Five): Hospitals and healthcare systems often mandate three professional references when evaluating a medical practitioner’s credentials. However, the credentialing specialist responsible for validating these references won’t waste time chasing unresponsive contacts. Listing only three references, especially if one is difficult to reach, can lead to prolonged processing times. By providing five references, you give the credentialing specialist more options to consider, which ultimately accelerates the process.
2. Keep Your Documentation Current Ensure that the following documents are kept up to date:
   • Council for Affordable Quality HealthCare (CAQH)
   • Drug Enforcement Authority (DEA)
   • CLIA Certification
   • Any other ancillary services requiring proof of accreditation
   • IRS Letter Confirming Established Tax ID Number
   • Articles of Corporation (LLC, PA, INC., etc.)
   • License
   • Malpractice Insurance If any of these documents require annual renewal, ensure that the documents provided by your physician are still valid.
3. Initiate the Credentialing Process Early: While the medical credentialing process typically takes 50 to 90 days from the initial application receipt, it could extend to 120 days based on the quality of the application and other factors. Thus, it’s wise to submit your forms early, especially at the beginning of the year. The sooner you begin, the sooner your physician can start working in your practice.
4. Familiarize Yourself with State Credentialing Requirements: Understanding your state’s specific medical credentialing prerequisites is crucial, particularly if you’re establishing a practice in a new location. This includes being aware of any additional fees that may be mandated by:
   • Medicare
   • Medicaid
   • Tricare or V.A.
   • Durable Medical Equipment Regional Carrier (DMERC) Stay informed about your state’s current requirements to facilitate a faster medical credentialing process.

Closing Thoughts on the Credentialing Process:

In some cases, outsourcing the medical credentialing process to a third-party provider can be a wise choice. These companies have established relationships with payers, making them well-versed in common mistakes and errors that can impede the credentialing process.