Navigating the credentialing gauntlet: Key actions for revenue cycle management

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* 1. On average, what is the estimated cost to credential a provider?

No cost

Per claim cost

$200

$1,000

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* 2. Is credentialing a good way to determine if a provider has any pending medical violations?

True

False

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* 3. Fill in the blank: Practices would do well not to ____________________ can do to its revenue cycle.

underestimate what a poorly organized credentialing process

understand long delays in processing new provider applications

underestimate the lack of communication from payers to medical practices

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* 4. If providers are not credentialed, they could face long delays in processing of their applications.

True

False

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* 5. What should be the goal to receive payment once a claim is submitted?

30 days

45 days

60 days

120 days

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* 6. If a provider is having credentialing issues will claims need to be reworked?

Yes

No

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* 7. What key performance indicators (KPIs) do claim denials impact?

Days in AR

Aging claims

Denial of procedures

Clean claim rate

A, b and c