Why Efficient Credentialing is Essential to Your Therapy Clinic’s Revenue

As a therapy clinic owner, you are no stranger to administrative tasks. However, there is a hierarchy of need when it comes to these responsibilities. Some tasks, such as scheduling, can be quite easy to hand over to an admin team or manage with the help of an EMR like TheraPlan, while others are a bit more sensitive. We would argue that one of the most critical things you apply your time and attention to at your clinic is keeping up with credentialing for your therapists. 

Becoming credentialed with an insurance provider is no small feat. Whether you are dealing with Medicare, Medicaid, or any commercial carrier, the process often involves spending hours on the phone (during your precious work day) and even more hours gathering the necessary paperwork. Long story short, credentialing for the rolling list of therapists on your payroll can become quite the nightmare.

While therapists are technically responsible for their own credentials, it’s no secret that they rely on clinic owners like you to keep up with the necessary steps. After all, knowingly submitting claims without credentials can backfire on your entire operation, not just on the individual therapist. If your therapists are providing services to patients and billing an insurance company with whom they are not properly credentialed, there will eventually be consequences, not the least of which is your potential loss of revenue! 

In order to keep cash flowing and allow for no break in therapy for your patients, it’s wise to create an organized plan and adhere to consistent guidelines when it comes to credentialing.

Here are a few things the TheraPlan team suggests for making your credentials record-keeping process more efficient:

  • Communicate openly with new hires. Creating transparency with any new therapists who join your team is essential to maintaining their credentials. Encourage new hires to be up-front about their current standing with each insurance, and ask for demographic data (such as social security number and NPI) right away to avoid any delay when it comes time to renew credentials. It’s a good idea to create a comprehensive calendar for all of your therapists that shows any upcoming expirations in one place.
  • Because each insurance credential differently, take notes on the specifics of each in a central location accessible to future admin staff. In each therapist’s file, be sure to note the date and time of every phone call or other interaction you’ve had with insurances and ask for the name of every representative.
  • Build a monthly process that makes sense for your clinic. If there are other tasks you complete on a regular basis, schedule the credentialing tasks in advance to the best of your ability. Rather than trying to fit it in when you have ‘free time’ and finding yourself stressed by deadlines or facing delays in billing, make applying for and maintaining credentials a top priority. For example, if you always complete payroll at a particular time of the week or month, build in some tasks related to credentialing so it doesn’t build up into a more daunting job.

Even after implementing these efficiencies, the paper trail will inevitably become too much to manage. That’s why we created a specific web-based place for these types of important records to live. Inside TheraPlan’s User Maintenance section, which is accessible to clinic owners and admin staff, there is an accordion labeled Credentials. Here, you can store all the essential demographic data you’ll need to refer to for each employee. Find out more about the administrative benefits of using our EMR here.

The benefits of maximizing efficiency and staying up to date with credentialing requirements are many. If you’re dedicated to keeping up with this building block of therapy clinic administration, you can minimize therapist turnover and create a solid, long-term relationship with your qualified staff. Your business revenue won’t suffer due to missing documentation. Perhaps most importantly, the community of patients you serve won’t experience any gaps in care.