Common Medical Credentialing Errors That You Must Absolutely Avoid
Common Medical Credentialing Errors That You Must Absolutely Avoid
Errors in medical credentialing can be detrimental to healthcare practices. Learn the most common credentialing mistakes that you must avoid.

Medical credentialing is one of the essential compliance requirements in medical practice today. Why? Because poor credentialing can lead to financial and legal implications for the medical practice. However, one needs to remember that credentialing is a time-consuming and complex task, which, if not done correctly, can lead to a significant loss of time and money. Owing to this complexity, errors in the medical credential process are a common sight.

Here are such medical credentialing errors that every healthcare practice needs to keep an eye out for. 


1.   Lack of Sufficient Credentialing Staff
Already being an extremely laborious and time-consuming task, medical credentialing becomes even more complicated when there aren’t enough staff members to handle the administrative burden. When a medical practice does not hire adequate staff, the current team becomes overburdened, making errors in the process. Even if there is sufficient staff, not having staff with appropriate expertise can cause errors in the credentialing process.

2.   Outdated Information of Providers
Another problem that arises in the medical credentialing process is the outdated information of healthcare providers. All providers are required to renew their licenses regularly. Even a small change in the credentials like a contact number or address needs to be kept up-to-date in the system. This is because any unverified or misreported information about the provider can lead to claim denials and cost the practice huge monetary losses.

3.   Divergence from State Compliance
When it comes to medical credentialing, the compliance prerequisites vary from state to state. Even the rules and regulations about the 
credentialing procedure can be different in every state. Not meeting these requirements is a significant error that can be a massive roadblock in medical credentialing. Deviations in compliance requirements can result due to several factors, including lack of knowledge and legal awareness, negligence of the staff, or being unaware of the standard regulations. 

4.   Incomplete Enrollment Applications
Incorrect or incomplete information in the enrollment applications can also be a huge mistake for any healthcare practice. A credentialing application requires detailed information about your practice, including the address, contact information, services provided, employment history, and average patient profile. Failing to provide this information or mistakes in the data can delay your credentialing process and sometimes lead to the rejection of the application. It is, therefore, advised to verify the information provided in the enrollment applications meticulously. 

5.   Errors in Data Entry
Most of the provider data used for credentialing is entered into a computer system via data entry. Data entry error is one of the most common credentialing errors and even a slight lack of attention to detail can render the credentialing process useless. Data entry errors include typo errors in which wrong or interchanged information is added into the system and missing information where relevant information is completely omitted due to a mix-up.

What is the Solution? Outsource to STAT MedCare!


With changing trends in medical practice, the challenges of maintaining a balance between providing services and handling administrative operations are high. Therefore, the best solution to streamline your credentialing process is to outsource your credentialing requirements to experts in the industry. Get in touch with us and make your way towards error-free medical credentialing.