6 Common Credentialing Mistakes Therapy Clinic Owners Make
If you’ve been managing credentialing for your therapists in house, you no doubt understand the challenges inherent in this complicated process. Gathering the data you need, spending precious time on the phone with insurance companies, and dealing with all the other headaches involved can lead to confusion and overwhelm. Sometimes you just want to get it over with, and we understand!
However, not paying careful attention to your methods related to credentialing can lead to careless mistakes and long-term inefficiency. While it seems tedious to stick with a plan for this kind of thing, the consequences of not doing so can include high therapist turnover, work-life imbalance for you and your staff, and even loss of revenue.
So, what’s the secret to getting your credentialing, and therefore your time, under control? In our experience working closely with clinics of various sizes, we’ve discovered a pattern in the way clinic owners handle the responsibilities of credentialing. Following are six common mistakes Clinic Connection’s team of experts has identified.
- Failing to collect credentialing data right away from new hires. When you bring on a new therapist, there can be so many details to take care of: training, scheduling, and payroll, to name a few. It’s easy to keep credentialing at the bottom of your list. Yet, not getting your new therapist’s demographic data and current credentials up front could cause a critical delay down the road.
- Making the process confusing for your therapists. Closely related to the previous common mistake, the way you interact with new hires and current staff members about the sensitive process of credentialing can be essential to your success with in-house credentialing. Some therapists may naturally want to be more hands-on, and others will be hard to communicate with. Ideally, your therapists will know from day one of employment that keeping their credentials updated is a priority for you and what you’ll need from them in order to do so.
We suggest creating a checklist-style document for new hires detailing exactly what you’ll need from them and when. Give direct instructions for how to share documentation to minimize the risk of their paperwork getting lost in your inbox. If you have an admin team, enlist them to create a process that may include electronic storage of all credentialing documents and a place to house records of which data has been collected or is missing per therapist. By anticipating every possible stage of the communication process that puts accuracy at risk, you’ll minimize conflict and build trust with your therapists.
- Being generally disorganized with expiration dates. Whether you’re dealing with a new therapist applying for an NPI number or renewing a provider’s commercial insurance enrollment, staying on top of deadlines is crucial. Requiring paperwork from your therapists in advance of expiration dates is critical to ensuring the quality and accuracy of the information you’re submitting on their behalf.
- Forgetting to take notes during phone calls with insurance companies or state health care agencies. If you’ve ever experienced the mess that can result from trying to communicate with insurance companies, you know that you should never rely upon your own memory or their records. Taking detailed notes during every phone call, including time, date, the name of the agent, and the specific requests or conclusions drawn can save you and you therapists many headaches. Of course, you’d want to keep these notes in a centralized location, perhaps an online document pertaining to only that company or agency. These notes should be accessible by anyone in your office who’ll be responsible for following up on enrollment applications, updated licensing submissions, background screenings, etc.
- Not following up about delayed credentials. Using the same streamlined document where you take notes during important phone calls, list a plan for follow-up and assign it to a team member right away. When you’re first trying to create habits around more efficient credentialing, it’s a good idea to add these minor tasks to your calendar or a reminders app on your phone. It’s your responsibility to follow up on new submissions and renewals, especially if you have patient appointments already scheduled beyond a provider’s credential expiration date. As you may have learned the hard way, a delay of just a few days can result in weeks of frustration for everyone involved.
- Letting non-credentialed providers treat patients! This unethical practice should not be on our list at all, but unfortunately, we find that clinic owners are far too lax about compliance. Ultimately, even if you want your therapists to be responsible for keeping their own credentials up to date, your clinic can come under scrutiny in the event of an audit. The annoyance of having to keep up with paperwork or deal with a temporary lapse is far less severe than what could happen if you turn a blind eye and allow them to treat without the proper credentials.
Avoiding all of the above can lead to more sound operational policies overall, since organization in one area can inspire you to identify other ways to take your business to the next level. Not only will you experience less stress as a business owner, but you’ll start to see the positive effects on company culture and internal communication. While these tips are great for maintaining compliance and productivity, perhaps the greatest advantage to auditing your credentialing practices is that you’ll ensure continuity of care for your patients because their therapists’ credentials will be less likely to lapse.
If you’re still overwhelmed after addressing these common mistakes, we recommend looking into outsourcing credentialing for your therapy clinic. Begin by reading our post about how to hire the right credentialing company.
