Navigating the complexities of healthcare operations, particularly the credentialing process, can significantly impact the financial health and operational efficiency of healthcare providers and organizations. At Fifth Avenue Healthcare Services, we’ve developed a strategic tool to confront and simplify these complexities—the Credentialing Calculator. Accessible at credentialingsucks.com, this innovative tool is designed to alleviate administrative burdens and illuminate the financial repercussions of credentialing inefficiencies.
What is the Credentialing Calculator?
Our Credentialing Calculator is a simple device crafted to combat the inefficiencies embedded in traditional credentialing methods. It extends beyond mere administrative support by quantifying the potential financial losses incurred due to credentialing delays, offering insights into improving their financial outcomes.
How Does The Credentialing Calculator Work?
Operating the calculator involves a few simple steps that yield comprehensive financial insights:
- Specialty Selection: Users start by double-clicking to select the provider’s specialty from one of 19 detailed options. They can also choose to use the category titled ‘Mixed Specialties,’ which uses an average based on the annual income data sourced from the Merritt Hawkins 2018 Review of Physician Recruiting Incentives.
- Number of Providers: Input the total number of providers in the group or enter ‘1’ for sole practitioners to tailor the financial projections accurately.
- Calculation of Financial Gains: The calculator then calculates the Potential Additional Net Income Per Provider and Potential Additional Net Income Per Group.
Additional details:
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- Insurance Carrier Times: Incorporating data from recent studies (as of 10/1/21), credentialing with major insurers such as BCBS, Aetna, and UnitedHealthcare averages 27, 33, and 9 days, respectively, through Primoris credentialing. The Primoris average of 37 days is based on a comprehensive case study conducted on 4/5/23, encompassing 38 different payers, including delegated and non-delegated payers such as Aetna, Medica, OK SoonerCare, and Blue Advantage PPO (BVP).
- NAMSS: This is informed by a NAMSS study, which demonstrates that using a Credentialing Verification Organization (CVO) can speed up credentialing by 5-7 days.
- The tool calculates using a national credentialing average of 92 days, with a reduced span of 37 days through Primoris, illustrating the rapid efficiency of our services.
Who Benefits from the Credentialing Calculator?
This tool is invaluable for:
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- Healthcare Administrators: Who are tasked with making informed decisions about resource allocation and strategic outsourcing.
- Medical Practices: The calculator will benefit both large groups and sole practitioners by assessing how enhancements in credentialing can translate to significant financial improvements.
- Healthcare Consultants: Consultants can utilize detailed reports from the calculator to formulate and recommend operational improvements.
Streamline Your Credentialing Process
By outsourcing primary source verifications to Fifth Avenue Healthcare Services’ credentialing verification organization (5ACVO) or payer enrollment to Fifth Avenue’s Primoris Credentialing Network, healthcare facilities can alleviate the burden of this crucial yet cumbersome credentialing process. Our credentialing calculator illustrates the return on investment from outsourcing and charts a path to improved care delivery and patient satisfaction.
Real-World Challenges in Credentialing
Understanding the Landscape: The credentialing process is fraught with discrepancies and regulatory hurdles that vary by state and provider type. Small practices often struggle with the resources needed to manage these tasks, while larger institutions battle the sheer volume and complexity of data management required.
Technological Advancements in Credentialing: Advances in AI and blockchain are poised to revolutionize the credentialing landscape further. AI can automate the verification of credentials in real time, while blockchain offers a secure and immutable ledger to maintain provider data, increasing trust and transparency in the credentialing process.
Impact on Healthcare Delivery: More efficient credentialing processes translate directly into better patient care. Providers can start seeing patients sooner, which is crucial in areas with provider shortages. Efficient credentialing also supports faster response times in public health emergencies, where rapid deployment of healthcare providers is essential.
Impact on Healthcare Economics: Streamlining credentialing processes can lead to significant cost savings. Healthcare facilities can allocate more resources to patient care by reducing the overhead associated with administrative tasks, potentially leading to lower healthcare costs.
Engage with Our Tool
Discover how the Credentialing Calculator can transform your credentialing process. Visit credentialingsucks.com and see firsthand the impact on your operation’s efficiency and bottom line. Let Fifth Avenue Healthcare Services help you streamline your credentialing process for better financial and patient care outcomes.
Conclusion
The Credentialing Calculator is more than a tool—it’s a transformative asset for healthcare organizations seeking to enhance efficiency, reduce costs, and improve service delivery. Embrace the power of advanced technology and strategic insights with Fifth Avenue Healthcare Services to optimize your healthcare operations.
More information about Fifth Avenue Healthcare Services
Fifth Avenue Healthcare Services is an NCQA Credentialing Accredited family of healthcare companies. Sister companies include 5ACVO (credentialing and primary source verification specialists), Fifth Avenue Agency (MPLI and medical malpractice insurance specialists), and Primoris Credentialing Network (credentialing and provider enrollment specialists with 54+ health plan and network provider enrollment options).
Fifth Avenue Healthcare Services originally published this article here. For information on Fifth Avenue Healthcare Services, please visit FifthAvenueHealthcareService.com or Contact Us.
