Protecting Your Practice from Healthcare Reimbursement Delays
Claim denials disrupt healthcare practice revenue, but ongoing credentialing maintenance prevents many issues. Expired licenses, missed CAQH attestations, or unreported provider changes can halt reimbursements and patient care. Preferred HCP’s healthcare credentialing services keep your practice compliant, contracts active, and claims flowing, protecting your bottom line.
Why Credentialing Maintenance Matters
Credentialing maintenance is a continuous process: it ensures providers remain eligible to practice and connected to insurance networks. By updating licenses, attesting CAQH profiles, and completing payer revalidations on time, practices avoid billing issues, compliance risks, and delays costing thousands. Industry data shows 15–20% of claim denials stem from credentialing errors, making maintenance critical for healthcare reimbursement protection.
Understanding the Causes of Claim Denials
Many denials arise from preventable credentialing issues:
Expired Licenses or DEA Registrations: A temporary lapse halts claims, delaying revenue.
Outdated CAQH Profiles: Missed attestations or old documents delay enrollment by 30–60 days, stalling patient access.
Missed Payer Revalidations: Medicare and commercial payers require recredentialing every 3–5 years. Missed deadlines cause over 50,000 provider deactivations annually, stopping reimbursements.
Unreported Changes: New addresses, tax IDs, or affiliations create mismatches, flagging claims for denial.
These errors disrupt revenue and patient care, costing practices thousands, as delays can reach $15,000–$30,000 per provider.
How Ongoing Maintenance Prevents Disruptions
Ongoing credentialing maintenance proactively prevents disruptions. Licenses, DEA numbers, and malpractice insurance are tracked and renewed before expiration. CAQH profiles are kept current with quarterly attestations and updated documents, ensuring payers verify credentials quickly. Payer revalidations for Medicare, Medicaid, and commercial networks are completed ahead of deadlines, often cutting approval times by weeks. Administrative changes, like practice relocations, are reported promptly, reducing denial risks and maintaining patient access.
Understanding the Compliance Risks
Credentialing errors risk more than revenue: they create regulatory liabilities. Missed Medicare revalidations can deactivate enrollment, barring providers from treating Medicare patients or billing. Services during deactivation may go unpaid, and intentional billing risks penalties. Staying compliant through proactive maintenance ensures uninterrupted care and avoids costly healthcare payer compliance issues.
Why Preferred HCP Is the Right Credentialing Partner
Preferred HCP’s Maintenance Service eliminates credentialing burdens. We manage payer communication, track expirations, and update profiles, ensuring accuracy and compliance. Our expertise prevents denials and delays, keeping your enrollments active and reimbursements secure. With our support, your staff focuses on patient care, not paperwork.
Take Control of Your Credentialing Today
Credentialing maintenance protects revenue, reputation, and patient care. Errors like missed revalidations or outdated CAQH profiles lead to denials and delays. Preferred HCP’s healthcare credentialing specialists ensure seamless compliance and billing. Do not let denials disrupt your practice: contact us today to schedule a consultation and secure your reimbursements.
