Seven Ways SMSC’s Credentialing Team Can Benefit Your Practice

Do you know the seven reasons you should outsource your credentialing to Spectrum Management Services Company (SMSC)?

A significant role of medical staff service professionals is conducting provider credentialing. Provider credentialing is a complex process of evaluating and verifying the qualifications, credentials, and competency of healthcare providers, such as (but not limited to) physicians, nurse practitioners, and physician assistants.

Roseann Napoleone, senior manager of credentialing & payor enrollment at SMSC, explains how we can help: “We have an experienced credentialing and payor enrollment team that partners with your practice so that you can focus on your core business: providing excellent patient care.”

Here are seven reasons your practice will benefit by outsourcing the credentialing process to SMSC.

1. Spectrum’s credentialing team brings superior knowledge and expertise

The CVO staff are certified Medical Staff Service Professionals with a wealth of knowledge and decades of experience.

2. Innovative and efficient technology for streamlined credentialing

“We have access to innovative technology, which eliminates the need to maintain spreadsheets and paper files, and reduces errors common in manual processes,” notes Roseann.

As a result, our workflows can shorten credentialing processing times and ensure timely reimbursement.

3. Compliance with regulatory requirements and accreditation standards

We stay updated on changing regulatory requirements and accreditation standards. Result: your organization remains compliant and can focus on patient care.

4. Improved quality of provider data

According to Roseann, “We improve the quality of your provider data, which streamlines and connects the credentialing, payor enrollment, and revenue cycle departments.”

Again, perhaps the most important benefit to your practice is a greatly improved patient experience. It also reduces the costs associated with payor enrollment delays and claim denials.

5. Hiring fewer additional staff = cost savings

When you reduce the need to hire and train additional in-house credentialing staff, you decrease operational costs, saving your practice money.

6. We can take care of your CAQH

What is CAQH?

The Council for Affordable Healthcare (CAQH) is a secure online data repository of provider self-reported credentialing information. CAQH is utilized by most major health plans and healthcare organizations at the time of a provider’s initial credentialing and subsequent re-credentialing. 

Creating and maintaining a CAQH profile can be time consuming. 

Here’s how Spectrum’s Credentialing Verification Organization (CVO) can establish and maintain your CAQH profile:

• We will review your existing CAQH profile to identify any inaccuracies in the profile data. If these remain uncorrected, they can result in claim denials and patient dissatisfaction.

• We facilitate the maintenance of your CAQH profile through data collection and ongoing expirables monitoring.

• We perform re-attestations every 120 days to ensure that the accuracy of the credentialing data stored in your profile remains compliant with CAQH requirements.

7. Providers focus on patient care rather than administrative tasks

By hiring SMSC as your medical staff services support team, your providers can focus on patient care rather than the day-to-day, time-consuming administrative tasks necessary to keep your practice and providers compliant. Our credentialing team’s strengths ensure that your clinical team can strengthen in the ways that matter most to them.

“One reason I love working at SMSC is the opportunity to collaborate with dedicated colleagues who are focused on achieving successful outcomes for our clients,” adds Roseann.

When we help your practice succeed, you can focus more on achieving successful outcomes for your patients.

To speak with Roseann Napoleone directly, please email her here. You can read more about SMSC’s credentialing services here.

SMSC offers a full suite of practice management services either collectively or on an a la carte basis: