By: Ray Jorgensen, Co-Founder, PMG Credentialing

As I have said for years, if you’ve been to one health center, well, you’ve been to one health center. Just like siblings raised in the same house by the same parents are unique, EVERY health center has its own personality, strengths, and flaws. When asking health centers, who does your credentialing, you can imagine the variety of answers:

• HR

• Billing

• Medical Directors’ admin

• Front Desk staff

• Medical Assistants

None of these folks are specifically trained nor necessarily skilled at CAQH  UPD (Council for Affordable Quality Healthcare Universal Provider Datasource), monthly application deadlines for each payer, understanding primary source verification processes, etc. More challenging is that any in-house credentialing is fraught with infrequency; i.e., if not performing credentialing and enrollment work every day, there is no mastery.

Aside from questionable skills and experience, do any of the aforementioned health center team members have loads of free time? We think not. Before the COVID PHE, health centers operated with lean staffing and the norm was folks multi-tasking to cover deficits in staffing levels. The elevated patient access for COVID testing, treatment, and expanded workload from telehealth and expanded temporary/mobile outreach have exacerbated the pressure on an already overworked team. Being overworked is bad enough… not getting paid because credentialing/enrollment is not done well is avoidable and intolerable.

If no one at your health center is afforded resources to master credentialing/enrollment, it will never be done well. Admitting there is a problem is the first big step. Contact a PMG Credentialing team member and learn how we help health centers avoid credentialing and enrollment pitfalls by partnering with a firm that understands health centers.

Since 1998, PMG has worked with hundreds of health centers in all fifty states and territories. Contact us today to begin a credentialing/enrollment partnership that will reap rewards immediately.