3 Tips to Improving Your Organization’s Medical Credentialing Process

Provider credentialing is complex for healthcare organizations. If you’re still managing your providers licensing manually —  i.e., Post-it Notes, paper folders, Excel spreadsheets, outdated software — the level of complexity only deepens. You’re also more susceptible to lengthy delays and errors. 

Credentialing practices that rely on paper trails or a decentralized set of systems that are hard to track and reproduce, such as emails and Excel spreadsheets, create frustration for teams. Without a modernized, automated process in place, oftentimes errors are caught after they’ve become a potential revenue risk. 

Modio Health has been helping healthcare organizations implement efficient day-to-day operating processes since 2012 and understands firsthand the frustrations and chaos resulting from credentialing the old way. The good news? Implementing a simple, technology-driven credentialing process for your team, like our platform, can save time and money. It’s about having not only the right technology, but also the right team and process in place. 

So how can you better position your team to avoid these credentialing pitfalls? Here are key examples of ways Modio’s OneView can help modernize your team’s credentialing processes.


Avoid duplications, delays 

Having different departments working with different processes means you’re probably duplicating credentialing work for some providers and entirely missing others. Getting consistent between multiple departments is key. Modio’s platform provides a centralized view within your own organization, helping your team figure out how to consolidate and standardize their process so everyone is working out of the same playbook. Modio’s platform allows for workflow optimization and automated real-time updates and helps teams see where there may be problems within their organization and identify how they can close those gaps. 

There is more efficiency in having one single standard, which we refer to as a Universal Provider Record. Everyone has access to the same data, and it’s all in one place for different roles and responsibilities to utilize. Modio’s platform distributes information to all parties in a timely manner and removes the chance of error and delays that currently plague the system.


Creating a safety net

Credentialing processes, especially in smaller organizations, are often reactive. For example, your practice may receive a letter that a physician has to be re-credentialed within 90 days. This, like many other credentialing processes, is dependent on a third party letting your organization know that something has to get done. Having your own structured system in place that’s proactive with timely alerts can save time and reduce reactive work that pulls resources from other projects. 

Our platform efficiently tracks the credentialing process and also creates a safety net, ensuring any hiccups or challenges are identified early, before it gets to the physician or client.


Don’t wait! It will only get harder.

Despite the benefits technology adds to the credentialing processes, your organization might balk at taking the leap because of the simple fact that you have done it on paper for so long. However, the cost of not upgrading and the compliance risk that presents to your organization is far greater than any challenges you may face by implementing our platform. As we’ve seen with our existing customers, replacing costly out-of-date processes with a platform like ours that can verify data automatically can lead to a 60 percent decrease in administrative costs.

With a growing number of payors, telemedicine, and organizational growth in general, the sheer volume of credentialing tasks at most organizations is making manual processes less and less manageable and increasingly risky. Healthcare organizations urgently need more sophisticated tools. It’s time to take that leap; it’s worth the effort. In the end, it will benefit your team and your providers and lead to better care for patients. 


To learn more about Modio, visit https://join.modiohealth.com/

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