A study conducted over a period of eight years by Johns Hopkins has revealed that more than 250,000 deaths are reported each year that can be attributed to medical error. These medical errors stem from various reasons, one of which is incompetency and malpractice on the part of the practitioners.

To address this issue, proper evaluation and validation of an individual’s credentials is crucial before authorizing them to practice in a healthcare setup. With a growing number of patients, healthcare practices are now focusing on hiring a higher number of medical practitioners to meet the healthcare needs of the population.

Healthcare practices are shifting their focus more to the process of verification and validation of the qualifications, competence, and past practice history of candidates for medical practice, which is called credentialing. This process is essential for minimizing medical errors, leading to optimal patient care.

Let’s discuss what credentialing in a healthcare practice is and how you can leverage it for your practice’s success!

What is Credentialing in a Healthcare Practice?

Credentialing is the process of verification and validation of qualifications claimed by doctors and other healthcare practitioners. The critical and essential process involves the verification of the healthcare practitioner’s education, training, certifications, malpractice coverage, and the validation of their expertise and previous performance records.

Credentialing confirms the practitioner’s competence to play a crucial role in the patient treatment process. This puts this vital process in the tasks that a healthcare practice should prioritize to ensure both patient safety and seamless operations. This meticulous process also plays a critical role in safeguarding the practice's reputation and ensuring compliance with regulatory requirements, fostering a secure and reliable healthcare environment for all stakeholders.

Why is Proper Credentialing Critical for Your Practice’s Success?

Patient satisfaction and trust play a huge role in the success of a healthcare practice, which necessitates providing the best possible services to them. Proper credentialing builds a strong base for optimal patient care in any healthcare practice. Here is how your practice can benefit from proper credentialing:

1. Prioritizing Patient Safety

Patient safety should be the first priority for a healthcare practice seeking success. A qualified and competent healthcare practitioner has the required expertise and knowledge for the provision of optimal patient care. Credentialing guarantees that only qualified and experienced medical practitioners are accepted into the healthcare practice, thereby safeguarding patient safety.

With the help of the intuitive design and interface of Practice EHR, a qualified healthcare practitioner can access accurate patient data anytime, anywhere. Accurate patient data remains crucial for proper diagnosis and an effective treatment plan, which ultimately maximizes patient safety.

2. Preventing Revenue Loss

Delayed and denied reimbursements from insurance companies due to medical errors can lead to thousands of dollars lost in revenue. Incompetent and underqualified medical practitioners are notorious for committing medical errors that impair the revenue management cycle of a healthcare practice.

Credentialing ensures the minimization of medical errors by carefully verifying and validating the credentials of medical practitioners before allowing them to practice. Practice EHR can assist with the prevention of revenue loss through its reliable medical billing services.

3. Boosting Patient Trust

Providing patients with access to qualified and exceptionally skilled medical practitioners instills confidence and trust in a healthcare practice. Moreover, it fosters patient safety and facilitates superior patient care by reducing the frequency of medical errors. Through a rigorous hiring process, credentialing establishes a strong foundation for patient trust and confidence.

Practice EHR can assist with the paramount task of building patient trust and confidence in your healthcare practice by providing your practitioners with reliable and secure EHR software to interact with their patients as well as other healthcare professionals, which could lead to better patient outcomes.

4. Improving Practice Reputation

Patients typically choose a reputable healthcare practice to ensure they receive the best possible care. To make this decision, patients often conduct online research to review the expertise and feedback of the medical practitioners affiliated with the practice before scheduling an appointment.

Credentialing guarantees that a healthcare practice provides services through proficient medical practitioners, contributing to an improvement in the practice's reputation. This, in turn, attracts more patients seeking top-quality care and fosters long-term practice growth, ultimately benefiting both patients and the healthcare facility.

5. Increasing Visibility

Esteemed medical practitioners often bring with them a loyal following of patients and clients, owing to their established trustworthiness. Credentialing serves as the gateway to attracting this substantial pool of potential patients by hiring highly reputable medical professionals. This influx of patients enriches the practice and enhances the overall quality of care, fostering a virtuous cycle of growth and excellence within the healthcare facility.

Additionally, this amplifies the healthcare practice's reputation and visibility in the medical community and among potential patients. As the practice becomes synonymous with excellence and reliability, it naturally draws in more individuals seeking high-quality healthcare services, further solidifying its position as a leading choice for medical care.

6. Thorough Compliance with Regulations

Healthcare practices are required to adhere to rules and regulations outlined by regulatory authorities such as HIPAA. A skilled and knowledgeable medical practitioner is well-versed in these regulations, a critical aspect for any healthcare practice to prevent violations. This commitment to compliance not only ensures legal adherence but also upholds patient privacy and trust.

Credentialing guarantees comprehensive compliance with regulations by rigorously reviewing the hiring process. Practice EHR aids in maintaining compliance by meticulously navigating the complexities of the medical billing and claim submission process. This two-pronged approach to regulatory adherence assures patients and authorities alike that the healthcare practice is engaged in the highest standards of ethical and legal conduct.

7. Avoiding Lawsuits

Payers, including insurance companies, commonly conduct audits in medical billing cases. If any malpractice is identified on the part of the medical practitioners during these audits, it can result in substantial fines imposed on the healthcare practice. Such fines and penalties pose a financial burden, tarnish the practice's reputation, and deteriorate patient trust.

Credentialing plays a key role in mitigating legal complexities by guaranteeing that only qualified medical practitioners are welcomed to the workplace. You can protect your practice from legal responsibility in malpractice claims by ensuring thorough and up-to-date credential verification for healthcare providers. This protects you from liability and prevents costly fines from legal disputes.

Challenges Associated with Credentialing

Although credentialing is undeniably critical for any healthcare practice, its inherent complexity and time-consuming nature cannot be ignored. Therefore, outsourcing other administrative tasks of your practice can be a mindful decision, allowing the practice to focus on credentialing, core patient care, and operational efficiency while ensuring regulatory compliance and excellence in healthcare delivery.

As a practitioner running a healthcare practice, you can dedicate more time to patient care by outsourcing the medical billing services. Practice EHR can help you with its exceptional practice management services by automating the claim submission, reimbursement, and follow-up process.

Practice EHR - ONE Solution to All Your Practice Needs!

Practice EHR is your ONE solution to all healthcare practice needs, from electronic health records (EHR) to practice management. The intuitive design and interface of its electronic health record software make onboarding easy for practitioners as well as the medical and administrative staff.

Practice EHR saves you valuable time that can be dedicated to crucial aspects of operating a healthcare practice, like credentialing. Request A Demo today and bid farewell to the intricacies of practice management!