TECHNIQUES FOR CENTRALLY MANAGING A CREDENTIALING LIFE CYCLE FOR HOSPITALS, PROVIDERS, INSURANCE PAYERS, CONTRACT MANAGEMENT, AND CLAIMS DATA PROCESSING ORGANIZATIONS

摘要

After realizing that few medical entities have ever viewed credentialing as an integral part of the revenue cycle, it becomes apparent why such medical entities have not viewed physician credentialing as an effective way to reduce administrative denials or as a way of generating incremental revenue. Given this realization, techniques disclosed herein improve computer operation to provide a systemic-level approach to medical revenue cycles. Exemplary aspects of the present disclosure identify where within the revenue cycle a medical entity is underperforming and what steps can be taken to rectify or remedy those underperforming areas. This identification process and subsequent remedies allow overall efficiencies of the medical entity to improve. Additional exemplary aspects of the present disclosure help eliminate redundant procedures that may occur at different points of the revenue cycle to increase efficiencies.