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View provider enrollment as a critical part of your RCM

View provider enrollment as a critical part of your RCM

Provider enrollment with payers is crucial, as it ensures proper reimbursement for services rendered, according to Patrick Doyle, senior vice president of Newport Credentialing Solutions.

Mr. Doyle shared the following tip with Becker’s Hospital Review: “To ensure every collectible dollar is received, provider enrollment must become an integral part of the revenue cycle process. Best practices should include regular payer audits to validate provider participation status, rigorous payer application follow up, monitoring of licenses and expiring documents, Council for Affordable Quality Healthcare re-attestations and re-enrollments. Furthermore, understand your at-risk revenue against your open enrollments. These are charges billed by providers when their enrollment status is in-process. In-process enrollments for payers with the highest at-risk revenue should be managed with the highest priority.”…

 

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