Protecting your practice from delays, denials, and compliance issues
Payer enrollment is critical for healthcare providers: it determines how quickly you can see patients, how accurately you get reimbursed, and how smoothly your practice operates. Simple mistakes in the enrollment process can lead to costly delays, denied claims, and compliance risks, often unnoticed until they disrupt revenue or patient care. Preferred HCP’s healthcare credentialing services help practices avoid these pitfalls with expertise and precision.
Incomplete or Inaccurate Applications
Submitting enrollment applications with missing or incorrect information, such as outdated addresses or mismatched tax IDs, is a common error. Even small mistakes can delay approvals by weeks or months, halting reimbursements and patient care. Industry data shows 15–20% of claim denials stem from credentialing errors, requiring time-consuming resubmissions that strain practice resources.
Missed Deadlines and Revalidations
Every payer has unique timelines and revalidation requirements. Missing a deadline can deactivate a provider, disrupting claims processing and cash flow. For example, Medicare revalidations, required every 3–5 years, lead to over 50,000 provider deactivations annually if missed. Tracking multiple payers’ deadlines is challenging, especially for practices with growing provider rosters.
Overlooking CAQH Attestations
Many commercial payers require updated CAQH profiles for enrollment. Failing to re-attest CAQH accounts, often needed quarterly, stalls the process, as payers cannot verify credentials. These oversights delay approvals by 30–60 days, limiting patient access and revenue. Proactive CAQH management is essential to avoid healthcare enrollment delays.
Lack of Follow-Up with Payers
Submitting applications is just the start: follow-up is critical. Payers often request additional documentation or clarification, and unanswered requests lead to closed or denied applications. Industry estimates suggest 20–30% of applications require extra follow-up, consuming hours weekly that could be spent on patient care or revenue-generating tasks.
Trying to Manage Everything In-House
In-house enrollment is complex and ever-changing, yet many practices rely on administrative staff juggling multiple duties. This increases errors, with 60% of practices using error-prone manual processes. As our prior article noted, delays can cost $15,000 to $30,000 per provider in lost revenue. While in-house management may seem cost-effective, the hidden costs of delays, denials, and compliance risks often outweigh savings.
How Preferred HCP Prevents These Mistakes
Preferred HCP specializes in healthcare payer enrollment services, ensuring accuracy and efficiency. We review applications for completeness, maintain CAQH profiles and attestations, and monitor deadlines across Medicare, Medicaid, and commercial payers to prevent lapses. Our team follows up directly with payers, addressing requests promptly to cut approval times by weeks. With a dedicated account manager, practices avoid reimbursement delays and compliance issues, focusing on patient care instead.
Take Control of Your Enrollment Today
Payer enrollment mistakes, from inaccurate applications to missed deadlines, have major consequences for revenue, compliance, and patient access. Preferred HCP’s credentialing specialists ensure your enrollment process is seamless and reliable. Do not let errors derail your practice: contact us today to schedule a consultation and discover how we can protect your revenue and efficiency.
