“Ugh, credentialing…”

Has that ever been your reaction to a new application or re-validation request? Experience has taught us all that the credentialing process is not for the faint of heart. I mean really, why does it have to be so difficult? All you want to do is obtain network enrollment, and service patients with optimum care. Why all the hoops?  Well, between the ever-changing regulations of credentialing, and requirements set by the NCQA, it all becomes cumbersome to meet the demands.

Modified Solutions offers streamlined services to help combat the woes of the credentialing process, but there are some common pitfalls that make an already tedious task, quite difficult to bare. Let’s take a look:

The Pitfalls of Credentialing

  • Lost of paperwork
  • Failure to meet re-enrollment deadlines
  • Expired credentials, licenses, and malpractice
  • Miscommunication or lack thereof between you and the medical staff office
  • Incomplete applications and missing documentation

…Shall we continue? You get the point.  Unfortunately, because of these pitfalls, your applications can be delayed for several months. The processing of credentialing in itself is already pretty extensive, ranging from 30 days to 5 months. So, compile that time lapse with unnecessary delays, and you have a recipe for disaster. But not to worry, Modified Solutions is here to help.

Successful Enrollment

When flow-charting your plan to execute your credentialing process, there are a few things to consider:

  • Are your credentials up to date?
  • Does your office staff have a designated enrollment specialist as one central point of contact for your office?
  • What is your follow-up process?
  • What procedures do you have in place to maintain your credentialing requirements?

In the grand scheme of things, this may not be something that would initially cross your mind as a top priority. However, having a detailed plan with these core questions answered will help you complete the enrollment process, and stay compliant.

Thinking of outsourcing your credentialing? Modified Solutions can help. Connect with us today, and see how.


Since 2001, Simone Harris has developed a solid foundation in administrative healthcare services and business development. She has 18+ years within the healthcare sector and serves as the Executive of Business of Operations and Compliance Officer. Modified Solutions is furnished with professional medical administrative resources that are firmly rooted in compliance, integrity, and experience. To learn more visit https://modified-solutions.com/.