Activate a denials prevention mindset with strong credentialing

Decreasing denials is a top priority for revenue cycle teams. Denials – and ultimately lost revenue – can result from missteps in the credentialing process. While detailed and labor-intensive, an effective credentialing process is key to addressing this challenge. Organizations that prioritize the credentialing process are positioned to move from a mindset of denials management to denials prevention.

Netsmart supports our clients in their effort to decrease denials and increase reimbursement by providing credentialing services. This revenue cycle management service helps streamline the provider onboarding process, organizes the collection of documentation, and takes a proactive approach to managing the details of credentialing.

Discover why credentialing was a key differentiator in Cornerstones of Care’s full implementation of revenue cycle management services.

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Credentialing and provider enrollment to fit your needs

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Individual provider enrollment

Payer panel enrollment/maintenance

Provider maintenance

Backlog cleanup

Full credentialing outsource

Privileging

Stay ahead by completing CAQH attestation every 120 days


See how we can help

How Netsmart RCM credentialing services can help

Individual provider enrollment

  • Medicare and Medicaid enrollment expertise
  • Maintain master provider roster
  • Monitor master provider roster for revalidation deadlines
  • Initiate/update/complete payer enrollment applications
  • Submit and track applications through to completion

Payer panel enrollment/maintenance

  • Maintain master roster by payer
  • Update roster as clinicians onboard/offboard
  • Notify payer of roster changes as applicable
  • Reconcile with payer at regular interval

Provider maintenance

  • Complete CAQH attestations every 120 days
  • Medicare/Medicaid revalidation management
  • Enrollment updates (demographic update, licensure change, pay-to address update, service location updates, etc.)

Experts in credentialing

The credentialing process gets increasingly more complex for organizations that operate in multiple states and have numerous payers. For every organization - but especially growing organizations - it's critical to understand the root cause of credentialing-related denials. If you're looking to improve your credentialing process or gain more insight to help identify and manage the root causes of credentialing-related denials, Netsmart RCM experts can help. We can assist with specific elements of credentialing or take over the entire credentialing function - whatever works best for your organization.

In this 4 minute clip, a Netsmart RCM expert outlines the 3 root causes that we see for credentialing. Listen in as she shares strategies for preventing and managing those credentialing challenges.

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Tackle denials with a proactive credentialing process

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