Make the case for payer delegation

Q: Any tips for making the case to my organization for why we should seek payer delegation?

Amy Niehaus, CPMSM, CPCS, MBA: If your organization is experiencing delays in revenue, you may not necessarily be aware of it, so talk to your CFO or billing department. If you’re writing off accounts receivable or holding claims, they’re tracking that and know exactly how much money they’re waiting to receive from payers or may have to write off and never receive from payers. That’s something that would influence whether you need to seek delegation.

Another element is that many employed practitioners have salary guarantees in their contracts now. You may have employed practitioners who aren’t enrolled yet but are still being paid a salary. That is additional money that is going out of your organization, but that practitioner is not seeing patients and bringing revenue into the organization.

At the end of the day, it’s really about the organization’s bottom line—the dollars and cents—that is creating the need for organizations to obtain delegated credentialing.

Source: News & Analysis

Found in Categories: 
Credentialing, Privileging