Archived Publications eBook: The Dollars are in the Details | Page 14

PRIORITIES FOR IMPROVEMENT
Respondents indicate that a number of initiatives are “very
important” to them as it relates to provider enrollment. Of
highest importance is “reducing time to enroll providers.”
Enrollment timeframes have a direct impact on the revenue-
cycle of an organization. Shortening this timeline can reduce
accounts receivables claims that are pending due to provider
enrollment and equate to less dollars at risk of being written-off
due to lack of timely provider enrollment with payers.
Q. Percentage saying that each activity is “very important.” (Base = 278)
85.8%
Reducing time to enroll providers
76.8%
Standardizing enrollment processes across org.
Vo
72.0%
Reducing needed resources, cost
Trouble collec
71.4%
Integrating credentialing, privileging, enrollment
69.1%
Integrating with CAQH and PECOS
Kn
66.7%
Improving provider satisfaction with process
Usin
65.9%
Improve financials of employing physicians, buying practices
52.2%
Prioritizing enrollment to high revenue generators
Too few employee
51.5%
Enrolling in EDI, EFT, ERA
Adding metrics to enrollment process 48.9%
Receiving delegated credentialing from insurance networks 48.9%
# o
38.2%
Website info on which plans providers are in
Lack of a
19.6%
Bringing provider enrollment back in-house
0
20
Waiting for pro
40
60
80
100
THE TWO BIGGEST CHALLENGES
The two biggest challenges faced by enrollment professionals
are collecting necessary provider data and dealing with the
complexity of payer applications.
“Credentialing and other systems that are used to establish
contracts between providers and health plans are riddled
with redundancy, with many organizations collecting virtually
identical information. The typical physician spends more
than three hours annually submitting nearly 18 different
credentialing forms with staff spending an additional 20
hours” per provider (Cutler et al, 2012).
Q. What are your organization’s biggest challenges in
the enrollment process? Check all that apply. (Base = 275)
85.8%
76.8%
53.8%
Volume/length of forms per provider
72.0%
42.9%
Trouble collecting enrollment info from provider
71.4%
37.8%
Keeping provider info up-to-date
69.1%
36.0%
Knowing each payer’s specific criteria
66.7%
32.4%
Using the most up-to-date payer forms
65.9%
30.2%
Trouble logging in to PECOS
52.2%
29.8%
Too few employees dedicated to provider enrollment
51.5%
28.4%
Knowing when changes are made
8.9%
26.9%
# of providers onboarded each month
8.9%
25.1%
Complicated forms
23.6%
Lack of automation fo