Coronis Health – Anesthesia

Payer Credentialing

Coronis Health takes the headache out of assessing licensed professionals, organizational members, or organizations’ backgrounds and legitimacy.

We know credentialing is a time-consuming task that requires diligence, which is why Coronis Health features industry-leading tech innovations to make it a painless process. We include credentialing services with our revenue management and medical billing services because we want you and your staff to focus on what you do best. Coronis Health’s Speciality Practice team has 100+ years of combined experience with various specialties, so we can get you promptly credentialed and paid.

What is Payer Credentialing?

Medical credentialing is a standardized process of establishing that doctors, nurses, and other medical providers are certified, properly trained, and have the required professional experience and qualifications to perform their jobs. This involves data collection, verifying information from various organizations, including medical schools, licensing boards, and other entities, and committee reviews by health plans. Coronis offers credentialing as part of our complete set of services.

Credentialing ensures that there are no reported issues suggesting that a provider is incapable of competently providing healthcare services to patients. It is vital to maintaining high standards of safety and care in the medical industry as it ensures the legitimacy of licensed healthcare providers, contributing to reduced risk of medical errors and increased patient safety.

From a financial standpoint, facilities and other organizations typically cannot receive reimbursements for their services from insurance providers, including Medicaid and Medicare, if they lack the appropriate medical credentialing. Credentialing is a task that every healthcare organization must perform, and it must be done correctly and efficiently. 

The Credentialing Process for Anesthesiology Clinics

Credentialing involves three basic steps, which are as follows:

1. Collect information

A healthcare facility or insurance company will ask the provider for information about his or her education, licenses, etc. The provider may submit the required information through a questionnaire or via email or software application.

2. Verify information

Facilities and insurance companies do the background work, directly corresponding with medical schools, licensing agencies, and other entities to verify the provider’s information. They may also use credentialing software to routinely check on information that licensing agencies make available online. 

Work management platforms enable them to record and organize provider information while receiving automatic updates when certain credentials have expired or when information needs to be re-checked. These checks involve monitoring reports about certain incidents or malpractice claims, or any other information that may potentially raise questions that would impact how a provider may be credentialed or re-credentialed.

3. Award credentials to the provider

After the facility has verified all required information with no issues, they can then award credentials to the provider. As for insurance companies, they can decide whether to approve the provider as an in-network provider after completing a similar process. 

Here is a summary of the commonly requested information or paperwork:

  • Proof of identity
  • Education and training certificates
  • Military service (if applicable)
  • Professional licensure
  • DEA Registration, State DPS, and CDS Certifications
  • Board Certification
  • Affiliation and Work History
  • Criminal background disclosure reports
  • Sanctions disclosure reports
  • Health status
  • NPDB
  • Malpractice insurance
  • Professional references

How Long is the Credentialing Process?

With a smooth and efficient process of obtaining and verifying information, a physician may be credentialed to provide services at a hospital or facility and approved to be in-network for a health insurance plan within 30 days. Under normal circumstances, the process may take longer, up to 60-90 days. In some cases, especially with insurance providers, the process can take six months or more.

Coronis Health’s Anesthesia Payer Credentialing Services 

Coronis credentialing services offer the following: 

Coronis Health has two credentialing services options, which can be added to our clients’ complete service plan. We can assist as needed or provide ongoing support to ensure a seamless process when new providers join your practice. Don’t risk losing revenue or patients because of credentialing. Let Coronis Health help.

Benefits of Outsourcing Your Anesthesia Credentialing

One of the telltale signs of needing to outsource credentialing services is when claims start getting denied. No facility wants to lose money or pay legal fees due to faulty credentialing. To reduce this burden and positively impact the quality of your care, you may prefer to hire a dedicated credentialing specialist or outsource the work to a medical billing and revenue cycle management company to perform the credentialing tasks for you. By outsourcing credentialing, you have a better chance of staying on top of the tedious, time-consuming process of credential management. Other advantages include:

  • Cost savings – Outsourcing provides more cost-efficient ways to reduce overhead and gain a more seamless operation. Dedicated experts perform the task better and faster compared to hiring and training in-house staff. 
  • Agility – Outsourced credentialing services can provide the most advanced software and rapid integration that can positively impact your scale growth.
  • Reduced errors – By using innovative software, you may significantly reduce errors that are common in manual processes. Advanced software can automatically filter out information and check for errors. You can also expect top-quality, end-to-end credentialing process management from the experts.
  • Better use of staff time – Outsourcing credentialing enables your staff to use their time in more effective ways while focusing on their core competencies. This results in happier, more productive employees who can deliver better patient care.
  • Quick turnaround – Outsourcing credentialing services ensures timely reimbursement. While the standard time it takes for healthcare organizations to verify credentials is from 60 to 90 days, an expert credentialing specialist can speed up the process, allowing providers to work without any worries.
  • Compliance – Outsourcing credentialing gives you access to expert knowledge and up-to-date resources. A credentialing expert stays abreast of the current industry, state, and CMS guidelines.
  • Patient confidence – Medical credentialing allows patients to place their trust in their healthcare providers. Patients who are confident in their doctors are more likely to remain with their current provider instead of looking around for other physicians. You gain the prestige that comes from having a staff of fully medically credentialed nurses and doctors. You not only gain a better reputation in the industry, but are also encouraging future excellence by nurturing your staff’s outstanding abilities.

Are you ready to outsource your credentialing services to the experts who also provide your revenue cycle management and medical billing? Let’s start a conversation.