The credentialing process can be cumbersome for both healthcare providers and health plans. Over the years, solutions have been developed to alleviate the burdens associated with this workflow. But, while advances have been made in automating credentialing, a new problem has emerged: plans and providers are using a multiplicity of platforms that do not communicate with one another. Now, a physician who contracts with 10 or more plans may use just as many portals, platforms and manual processes to provide credentialing information to each.
In short, the benefits of automation are being lost to a fragmented system.
According to new analysis from CAQH, the burden associated with the current disjointed credentialing system does not impact providers across the country equally. In particular, providers in rural areas bear a much higher cost.
There is, however, reason for optimism. In a new report, CAQH shows that costs and complications are minimized when large numbers of providers and plans use a single automated platform.
For example, CAQH found that physician practices that use multiple methods for credentialing spend $2,068.00 per month on this workflow, while practices that used one platform spent only $1,249.86 per month.
To read “Credentialing - All for One,” click here.