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Eight Common Physician Credentialing Mistakes

Poor execution of physician credentialing can result in serious consequences like financial losses on provider services, delays in claim reimbursements, fines or penalties, exclusion from federally funded programs, and harm to patients. To mitigate risk, organizations should avoid the following common mistakes: 1. Relying on limited staff and administration, 2. Having incomplete physician enrollment applications, 3. Allowing a physician to treat patients before credentialing is completed, 4. Not updating and verifying information, 5. Covering up prior adverse action, 6. Failing to report adverse actions, 7. Failing to report adverse actions to the National Practitioners Data Bank (NPDB) and 8. Failing to take peer review activity seriously.


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Post By Ken Shafton (2,108 Posts)