At 1ˢᵗ Credentialing we know that when our clients place their trust in us, we take that responsibility seriously by communicating with our clients to create a transparent and collaborative partnership.
Healthcare organizations of every size realize that hiring 1ˢᵗ Credentialing is the most economical and efficient way to solve their credentialing needs. We have the training, expertise and commitment it takes to keep a complex process moving forward at all times.
1ˢᵗ Credentialing supports healthcare practices of all sizes - from health systems, to community hospitals, to large group practices, to smaller organizations. We help get your providers up and practicing as fast as possible.
Learning more about the credentialing process benefits us and our clients. 1ˢᵗ Credentialing offers regular videos and newsletter updates to bring our clients and those interested in innovations in credentialing up to speed.
Payor Enrollment Mistake #6: Failing to Verify Your Supporting Documents are Current
DO NOT WAIT! That is our message and our mantra when it comes to perishable documents. What is a perishable document? A perishable document is a document that has an expiration date.
One of the most common mistakes people make, when submitting their payer enrollment application, is submitting their application with expired supporting documents. Like rotten fruit, expired documents are spoiled. Submitting expired documents will delay the payer enrollment process and may result in your application being rejected.
This is why our message to you is DO NOT WAIT! When it comes to perishable documents, do not wait until the last minute or let them expire. It is important to stay in front of the renewal process and make sure your supporting documents are properly maintained and current.
To help you stay in front of the process, we have provided a checklist of five KEY perishable documents we recommend you actively monitor and ensure are current prior to submitting your payer enrollment application.
Medical Licensure – You must hold an unrestricted and current license to practice for each state you practice in. Each state board requires that you renew your license every 2 to 3 years. If your license is not renewed by its expiration date, you are prohibited from practicing. If you continue to practice under and expired license, you may face many legal ramifications.
Why this matters: When your payer enrollment application is reviewed, if the date on your submitted medical license has expired, your application will be rejected, even if, you successfully renewed your license prior to expiration. If your current license is about to expire, renew your license before submitting your application. Remember the application process can take 30 to 60 days.
DEA – Like your medical license, your DEA Registration has an expiration date and is required to be renewed every three years. If you fail to renew your DEA license your prescription writing ability for schedule four drugs will be revoked.
Why this matters: If your proof of DEA Registration is expired or expires prior to your payer enrollment application review, your application will be rejected.
CAQH – Avoid your CAQH account from lapsing. This is such an important step in the payer enrollment process, you will find “avoiding your CAQH from lapsing” as the #1 mistake to avoid in our top 9 list.
Why this matters: The CAQH is a database most payors use for medical credentialling you into their network. Without an active or current account, your payer enrollment application will be rejected.
CEUs – Each state requires a certain amount of continuing education units each year. If you lose track of time and don’t meet the required number of CEUs, you may be sanctioned by your state board.
Why this matters: If you are sanctioned by your state board, the sanction will follow you, even after you meet the CEU requirements. It is a permanent mark. Such sanctions can impact your payer enrollment application and delay the process. It is best to avoid any mark to your record.
Malpractice Insurance – Forgetting to renew your malpractice insurance can lead to disastrous consequences. Keeping your malpractice insurance up to date is critical.
Why this matters: If your proof of malpractice insurance is expired your payor enrollment application will be rejected even if you have renewed it. When submitting your payer enrollment application, make sure you provide the most recent proof of insurance that will not expire in the next 30 to 60 days.
In our experience, most practices keep their license, insurance, and other regulatory requirements current. Remember, the mistake to avoid is submitting an old document or a document that will expire in the next 30 to 60 days. Make sure everything is current and DO NOT WAIT!
Our credentialing experts are here to help you assess exactly which solutions you need and let you know how inexpensively we could put you on the right track. 1ˢᵗ Credentialing includes primary source verification and payor enrollment for all insurance networks including Medicare, Medicaid, Medi-Cal and insurance networks. Don’t wait another minute, contact our terrific team today!