Credentialing vs Enrollment: What Your Office Needs to Know
- Credentialing vs Enrollment:Credentialing checks a provider’s qualifications; enrollment lets them join insurance networks and receive payments. Both are essential.
- Why It Matters:Without credentialing and enrollment, providers can’t bill insurers—leading to delayed income and unhappy patients.
- 2025 Trends:Digital tools like CAQH and PECOS are speeding things up, but 1 in 3 doctors still face issues due to outdated info or tech glitches.
- Common Mistakes:Starting late, missing deadlines, or not updating CAQH regularly can cause claim rejections and payment delays.
- Best Practices:Start 90 days early, use a master checklist, track renewals, and prioritize quality documentation before seeing patients.
- Real-World Impact:Delays in paperwork mean months of lost revenue and billing issues for new hires—costing both time and trust.
- Solution with Practolytics:Practolytics handles credentialing end-to-end, reducing denials and delays, ensuring providers can bill from day one. Visit Practolytics.com.