Credentialing: A Coin with Three Sides

Visualutions is pleased to present a new value-driven service: Credentialing!  Whether you're seeking help with professional verification of your provider(s) or seeking to enroll with more payers, Visualutions can help!

As experts in community health revenue cycle solutions, Visualutions knows firsthand how important credentialing is to your bottom line.  We believe that caring for our underserved is a critical facet of our national healthcare system, not only in adding value while reducing costs, but also in improving the health of our communities.

The term Credentialing has become a broad term used to refer to professional verification, network enrollment, and privileging.  Although they are coined of the same, they are each a separate entity or process, or a different side of the same coin.

Professional Verification is the process of collecting and validating information for a provider, including their education, training, experience, etc.  Visualutions expert staff will assist your office in the collection, collaboration and organization of data, which is securely stored for use in the verification process.

Provider Enrollment is the process of collecting and verifying the healthcare provider's credentials (their education, training, experience) and submitting the required documentation to enroll the provider into payer networks which will allow them to bill for services rendered.  Because this process is tedious, time consuming, and on-going, Visualutions is committed to doing the work and investing the time so you don't have to.

Privileging is the process of giving permission or granting approval for a healthcare provider to carry out or engage in specific clinical activities within the provider's scope of practice, based on verification of the provider's credentials, education, training, and experience.  Typically privileging refers to a hospital or healthcare facility authorizing a provider to treat patients within or on behalf of the organization.  Although we cannot grant privileges to a particular facility, we can certainly help with the verification process.  As your providers are settling in with their new group, facility, or organization, we will work on getting them enrolled with multiple payer networks, both government and private, so that there are no time delays in receiving payment.

Click here to learn how you can protect your revenue stream and safeguard your health center today.