Demystifying Credentialing Myths: Unlocking the Power of Technology in Healthcare

There can be many barriers and challenges to technology adoption in healthcare — even when these innovations work to make healthcare processes better. Provider credentialing is one of those complicated processes that is not always well understood but is necessary in order for clinicians to practice medicine. It’s also a process that technology can improve in many ways. Because of its complexities, healthcare practices may underestimate the benefits (and the importance) of a modernized credentialing system. In this article, we will debunk common credentialing myths and shed light on the potential of modernized credentialing systems like Modio’s OneView.

Myth: Credentialing software is only beneficial for large organizations.

Reality: Credentialing software can be advantageous for organizations of all sizes. While larger organizations may have more complex credentialing needs, smaller healthcare practices can also benefit from the automation, efficiency, and accuracy that credentialing software provides. It helps improve compliance, reduce errors, and enhance the overall credentialing process. At Modio, we work with more than 800 clients, which encompasses medical organizations of all sizes including ambulatory surgery centers, private practices, and Federally Qualified Health Centers. 

Myth: Credentialing software is expensive and not worth the investment.

Reality: While there may be costs associated with implementing or switching to a credentialing software, it is important to consider the long-term benefits. Moreover, many software solutions offer various pricing options, including scalable plans suitable for different organizational sizes and budgets. The time and cost savings gained from automating manual processes, reducing errors, and improving efficiency can outweigh the initial investment. It shouldn’t take more than 80 to 120 days to verify data points that have been verified multiple times throughout a provider’s career, yet this still happens for healthcare organizations using manual means to credential providers. Using OneView, Modio has seen turnaround times of less than 20 days in some instances when the software, staffing departments, and processes are aligned and optimized. 

Myth: Credentialing software automates the entire credentialing process.

Reality: While credentialing software can streamline and automate certain elements of the credentialing process, it typically doesn’t handle the entire process from start to finish. It assists with tasks like application management, custom status reports, document tracking, compliance alerts, and verification, but there are still human-driven steps involved, such as reviewing, gathering e-signatures, and making final decisions.

Myth: Credentialing software eliminates the need for human involvement.

Reality: Building a bit more off of the previous myth, credentialing software is designed to enhance and support the credentialing process, but it still requires human involvement and oversight. “Talk about medical progress, and people think about technology,” wrote the surgeon and author Atul Gawande in a 2011 issue of The New Yorker. “But the capabilities of doctors matter every bit as much as the technology. This is true of all professions. What ultimately makes the difference is how well people use the technology.”

While credentialing software can automate certain tasks, such as data entry, document tracking, and verification, human professionals are necessary for making decisions, evaluating qualifications, conducting interviews, and ensuring compliance with industry regulations and standards. Medical professionals play a vital role in effectively utilizing the technology.

Myth: Credentialing software is one-size-fits-all.

Reality: Different organizations have unique credentialing requirements, workflows, and compliance standards. Credentialing software solutions typically offer customization options to adapt to specific organizational needs. Organizations can configure the software to align with their specific processes, requirements, and regulations, ensuring a tailored solution that fits their operations.

In the evolving healthcare landscape, it’s important that we break free from outdated processes that no longer serve the sector. The healthcare sector has been grappling with issues like provider burnout and staffing shortages for a considerable time. It is crucial to enable providers to work flexibly, matching their availability and location with the needs of patients, without being hindered by antiquated procedures that delay care. By dispelling common misconceptions about provider credentialing, we can work to facilitate the adoption of approaches that will ultimately lead to improved, expedited, and safer healthcare.

For more information about how Modio’s OneView can benefit your organization, visit us today.

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