Purpose of Provider Credentialing and Its Importance – All You Need to Know

Medical credentialing has an important role in impacting your medical billing process since it stands the main reason for building patients’ trust upon your practice with the communication you maintain between your patient and the insurer. Provider Credentialing is considered as high priority and has to be performed before hiring a healthcare provider or during the hiring process, to make sure all the information is up-to-date with your provider.

Purpose of Provider Credentialing and Its Importance - All You Need to Know, Credentialing, Credentialing provider

Why Provider Credentialing is important?

# Improves trust among patients

Trust plays a crucial role between you and your patients since they believe that you are high professionals and take better care of them. If patients do not know their doctor’s qualification, they may not gain complete trust in the health care given by doctors to them. Therefore, assessing and verifying your qualifications and experience in the specialization create confidence in patients and allow them to develop trust on their select healthcare providers.

# Avoids revenue loss

Partnering with insurance providers becomes a mandate for healthcare providers to have huge patients approaching for treatment, since most patients are covered under some insurance policy. Majorly, physicians and other healthcare professionals should produce a list of document verifications to insurance to be eligible for reimbursement expenses.

If credentialing is not done properly, it leads to the rejection of claims and patients’ bills, which may again show a drop in the revenue drastically. But however, many healthcare professionals without considering credentialing as more crucial, may even ready to lose out thousands of dollars on claims sent before credentialing process is done.

#Reduces the risk of medical errors

A survey states that around 98,000 Americans die from medical errors every year, which worries and compels industry leaders to conduct campaigns for improving the standards and brings exposure to disciplinary actions against healthcare workers. Therefore, the need for credentialing healthcare providers becomes a priority primarily for individual practitioners/physicians, who find it difficult to do credentialing at the end.

Moreover, with everything being digitalized and automated, the room for making human errors is way reduced.

# Supports in the hiring process

Medical credentialing involves background verification of physicians/practitioners which requires their education, work experience, residential history and licensing details to be verified. This procedure happens during the time of hiring a physician to ascertain if they are qualified to perform their duties properly. Moreover, physicians to become a member of the network must need credentialing.

#Enhances Practitioner’s business

Medical Provider credentialing allows medical practices and solo physicians to treat patients with health insurance. Moreover, we could see high numbers of patients with health insurance in the present scenario. This automatically boasts increased clientele for practitioners. In this way, patients also find it good and feasible to meet the same physician again and again. Therefore, credentialing highly supports physicians with recurring patients.

# Improves the reputation of health practices

If you have undergone and completed credentialing, it definitely adds value to your practice when your patients search for healthcare professionals and look at certain aspects that satisfy them to come to your facility. Some patients may have insurance and some may not. But having credentialing done, the respective physician can treat patients with or without insurance.

# Cost-saving approach

In the current condition of the world’s economy, medical practices and practitioners look for highly cost-effective solutions so that it saves them some money for enhancement of their operations. With e-credentialing being introduced and implemented, all facilities can be easily migrated from paperwork to cloud-based computing solutions, thus reducing your overall costs along with ensuring safety and proper care of people.


Thus credentialing provides more benefits to healthcare professionals and results in increased third-party reimbursements and beat the current competition. 24/7 Medical Billing Services is a third-party medical billing outsourcing company and experts in providing credentialing services for practices and physicians. If you have not acquired credentialing yet, then it is high time to do it right away. To contact 24/7 Medical Billing Services, you can call the number +1-888-502-0537 and fix an appointment.

Read More : How Good Is Your Credentialing for 2021? – Talk to Experts of 24/7 Medical Billing Services

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