Maximizing Revenue Through Strategic Contracting and Credentialing

Introduction:

Credentialing and contracting a powerful tools for maximizing revenue. In this post, we’ll cover how to assess your existing business strategy and determine whether contracting or credentialing could be the next step toward achieving your goal. We’ll also look at some of the common pitfalls that can derail your effort, and how to avoid them.

Maximizing Revenue Through Strategic Credentialing:

Strategic contracting can be a valuable tool for hospitals to optimize revenue.
Contracting is a business process that involves the exchange of goods or services for money. It’s used by many organizations, including hospitals, as a way to increase revenue by selling services at a higher rate than what they cost.

Hospitals can maximize their revenue by strategically contracting with other organizations to provide greater value to patients and payers while improving patient experience during hospital stays

Hospitals can also use data to better understand their markets and provide a higher level of service that patients value. Hospitals have traditionally used contracting as a way to increase revenue by selling services at a higher rate than what they cost. However, with the rise of accountable care organizations (ACOs) and bundled payment, hospitals need to rethink how they contract with payers because it’s no longer just about price, Instead, hospitals should focus on providing greater value while improving patient experience during hospital stays.

Maximizing Revenue Through Strategic Contracting:

When you’re looking to maximize revenue, one of the most effective ways to do so is through strategic credentialing. Credentialing is the process of verifying the credentials of an individual or organization to ensure their qualifications are consistent with the requirements of the position. It’s used to determine if an individual is qualified for a specific purpose and can be used in a variety of industries, including healthcare, education, and more.

Credentialing provides several benefits for both employers and employees:

Credentialing Management:

Credentialing management is a critical component in the revenue cycle management process. It involves ensuring that providers are ready to provide quality care, as well as verifying that they have completed all required training and education.

Providers need to be credentialed by an organization such as JCAHO or CMS before they can begin practicing medicine at a hospital or clinic. Credentialing managers make sure that providers meet the standards set by these organizations, which helps ensure patient safety while also reducing legal liability for the hospital or clinic if something goes wrong with the treatment provided by an uncertified provider.

As the healthcare industry continues to grow and evolve, so too do the needs of hospitals and clinics. Credentialing management is essential in maintaining quality care, which can be challenging as more providers enter into the system Credentialing management is a critical component in the revenue cycle management process. It involves ensuring that providers are ready to provide quality care, as well as verifying that they have completed all required training and education. Providers need to be credentialed by an organization such as JCAHO or CMS before they can begin practicing medicine at a hospital or clinic. Credentialing managers make sure that providers meet the standards set by these organizations, which helps ensure patient safety while also reducing legal liability for the hospital or clinic if something goes wrong with the treatment provided by an uncertified provider.

Revenue Management

Revenue management is the process of managing revenue to maximize profitability. Revenue management can be categorized into two categories:

The two categories of revenue management are complementary. For example, strategic contracting can help you increase your money by selling additional products or services to a customer. However, without strategic credentialing (such as setting up a credit card processing system), you won’t be able to take advantage of those higher prices.

Provider Credentialing

Provider credentialing is the process of vetting providers for their ability to provide the services required. It also ensures that providers can provide those services promptly.

Provider credentialing should be considered part of any contracting strategy, as it can help you:

Avoid Project delays by ensuring contractors have the necessary equipment and personnel to perform their work and protect yourself from liability by verifying that each provider has insurance coverage.

You can maximize revenue with strategic credentialing

Strategic credentialing is a process that identifies the most suitable providers for your patients. When you implement strategic credentialing, it can help you maximize revenue, reduce costs, and improve patient care.

The first step in strategic credentialing is to identify how many procedures are performed in your facility each year by different types of providers (e.g., surgeons or independent medical examiners). Next, create a list of all possible providers who perform those procedures–including physicians from other hospitals or doctor’s offices; hospitals; independent practitioners such as radiologists and pathologists; clinical laboratory services companies; pharmaceutical companies with clinical trials programs; medical equipment manufacturers offering equipment used in surgery; etcetera! Then score each provider based on their expertise/experience level relative to the type of procedure being considered (e.g., score 1-5 if they have never done this procedure before). Once you’ve scored each potential provider against all criteria listed above then compare those scores against one another until only one name remains at the top: “This person should do this job!”

The next step is to contact providers on your list and ask them if they are willing to be considered for a job. Set up interviews with each one, including a discussion about their experience/expertise in this area of medicine and how many procedures they have performed over the last year. Invite them back into the facility for an in-person demonstration of their skills (e.g., allowing them to perform surgery on a cadaver).

Conclusion:

We hope that you have found this article helpful in understanding how to maximize revenue. As always, we are here to help you with any questions or concerns that arise when it comes to credentialing and revenue management.