Modio Health’s Extended Credentialing Services team unveils expanded service to streamline credentialing for providers

Modio Health’s Extended Credentialing Services team unveils expanded service to streamline credentialing for providers

Modio Health’s Extended Credentialing Services (XCS) team brings 212 years of combined experience to the clients and providers they serve daily to improve and make clear sense of the often complex task of provider credentialing. Credentialing is indeed complicated, yet it’s one of those mandatory healthcare processes that are necessary — not just for providers to be able to work and receive compensation, but also for patient safety. 

In addition to the medical provider credentialing services Modio has been facilitating for over a decade, Modio’s XCS team is now offering hands-on credentialing support to single providers, helping them navigate the rules, regulations, and paperwork that come with the credentialing process. “We like to say that our team can take a provider, fresh out of school, and guide them through the entire credentialing process until they are ready to bill for services,” shares Amy Aymar, Credentialing Operations Manager at Modio. “We can get them licensed; affiliated with hospitals; and enrolled with federal, state, and commercial insurance payors.”

Modio’s process step-by-step

The XCS team begins by reviewing each provider’s individual licensing needs and, based on the support needed, will put together a comprehensive plan to obtain the license(s) the provider needs, such as state license renewal help or a first-time state license application. From there, Modio assigns a dedicated licensing specialist from their expert XCS team to support. The provider’s XCS specialist understands the requirements of the licensing boards to handle the heavy lifting and uses OneView, Modio’s cloud-based modernized credentialing platform, to easily gather and safely store important data and documentation from providers. The XCS team will provide frequent status updates to providers as well as be on hand for any issues or questions the provider may experience. 

Modio’s XCS team also universally have their Provider Enrollment Specialist Certification (PESC) — the only certificate available for professionals to showcase their expertise in a growing market. Susan Collier, VP of Quality Management and Operational Services, explains, “Achieving this certification demonstrates to our clients that they are working with a team of professionals that has achieved the highest level of proficiency in payor enrollment services.”

In addition to being complex, credentialing is very time-consuming, causing delays in providers being able to practice medicine and see patients, especially for those whose employers do not have credentialing services baked into their process. Rachel Woodhouse, Senior Manager, XCS, explains, “In some cases, a hospital will have a medical staff office that can help with some of these aspects, but if you don’t have an employer or group that helps or does it for you, the provider is responsible for all of it. If they don’t have a partner like Modio, the practice does it on their own.”

What do high-touch credentialing support services look like?

Modio’s XCS team helps providers with:

  • State license: Initial, renewal, reinstatement
  • DEA: Initial, license renewal process, reinstatement
  • Controlled Substance Permit: Initial, renewal, reinstatement

The XCS team averages 60 days to enroll providers with payors across the U.S. and has a 90% client retention rate. And clients are seeing the impact. “Before partnering with Modio, credentialing issues were costing us up to $400,000 in lost revenue,” says Mark King, Market Director of Physician Services, Logan Memorial Hospital (a Scion Health Hospital). “Since working with Modio’s team, we’ve seen a dramatic improvement in our payor enrollment and claim processing, directly impacting our bottom line. With Modio’s help, we’ve been able to recover that lost revenue and ensure smooth operations.

In the last year, the XCS team has processed nearly 9,500 credentialing service requests, demonstrating our commitment to efficient provider onboarding

In the healthcare sector, Modio is known for its expertise and comprehension of the complexities of healthcare credentialing, understanding its importance for ensuring patient safety and high-quality care, but also acknowledging it can be challenging and time-consuming. Healthcare providers are under a massive amount of pressure, facing ongoing workforce shortages, surging rates of burnout, and not enough time with patients, among other challenges. By working to streamline the credentialing process and reduce credentialing times for single providers, Modio’s XCS team can alleviate more than 90% of their burden, freeing them up to spend more clinical time with patients, without the added burden of navigating the intricate details of credentialing.

To learn more about Modio’s credentialing services, please visit us today.


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