If you are a therapy clinic owner, we would venture a guess that you are no stranger to the Council for Affordable Quality Healthcare (CAQH) and what membership means for the continuity of your team’s credentialing experience. It is essentially a central application hub for various insurance credentials, and seems like a no-brainer. Of course, there is also the fact that many insurance companies actually require that all credential submissions happen via CAQH. These choices by the movers and shakers at large insurance companies have certainly made this almost an industry standard in 2020.
Mandating CAQH membership for your entire team can therefore be helpful as you continuously balance rolling expiration dates and bringing on new hires. However, fully implementing clinic policies that support accurate and consistent credentialing is easier said than done. Keeping an up-to-date account that is attested every four months is not light work and needs to be a priority for everyone involved.
Despite the fact that credentialing is technically the responsibility of individual therapists, it ultimately falls on you, the clinic owner. That’s largely because not keeping up with it can present a sizable risk and potential revenue loss for your business. Whether you have admins or you’re managing on your own, it’s overwhelming to keep up with therapist credentialing for CAQH (personal data, current documents, and list of insurances, to name a few items).
If your office does not already run like a proverbial well-oiled machine, this type of paperwork nightmare could overtake your administrative processes. In our experience overseeing the admin side of countless therapy clinics, many make credentialing more difficult than it needs to be. Like any other small business responsibility, efficiency in this area is very much about standardization. Have a central place (preferably digital and easily accessible) to house all the important data for each person in need of credentials, and you’ll immediately cut down on the time spent searching for correct info.
No surprise, we highly recommend an EMR for this! As you may have already discovered, though, not all EMRs are created equal.
In the same way that we focused heavily on building user-friendly documentation templates into our software, we also designed TheraPlan to make getting organized for credentialing easier. In each user’s profile within User Maintenance, there is an accordion (section) specifically for keeping credentialing data and uploading a therapist’s pertinent documents and personal data. Here, you will see that it’s possible to add expiration dates for board certifications, which allows our application to work with you in making the process seamless.
This section is only accessible by you as the owner, and any admin users you specify. Every move inside the system is traceable, so there will never be a question about who made changes to a user’s file. Once you’ve input all the necessary information the first time, the designated person in charge of credentialing for your office can then update it as necessary with just a few clicks. One additional benefit: TheraPlan is web-based, so it’s accessible from any device anywhere.
Even if you are already a TheraPlan user or have implemented some processes for therapist credentialing with CAQH, you may need some additional guidance to avoid costly mistakes. For this reason, we’ve partnered with the credentialing pros at Clinic Connection and several other companies specializing in Florida therapy to help clinic owners like you.
We invite you to reach out to us before making any changes to your credentialing processes. Not only can we get you set up with a modern, therapy-specific EMR, but we can connect you with our network of Florida therapy experts.