Making Credentialing and Onboarding Personal: A Roadmap for Provider Success

In a world where healthcare providers are more essential than ever, we must keep our onboarding processes manageable. It’s not just about getting someone through the door; it’s about ensuring they feel valued, supported, and fully prepared to dive into their role. This all starts with how we handle credentialing and onboarding. It’s got to be personal, transparent, and an integral part of their training within our organization.

The Onboarding Call: Where It All Begins

Let me tell you—an onboarding call is one of the most powerful tools we have. It’s our first chance to connect with new hires and set the stage for their entire experience with us. This isn’t just about going through the motions. It’s about laying out what they can expect, walking them through the credentialing process, and, most importantly, showing them that we’re here for them every step of the way.

Making that call isn’t just a nice-to-have; it’s a must. It sets the tone for open communication and ensures that they know exactly what’s going on from day one and who they can turn to with questions. This early connection builds trust and makes everything else smoother down the line.

Keep Them in the Loop: No Surprises

If there’s one thing I’ve learned, nobody likes to be left in the dark—especially regarding something as crucial as credentialing. That’s why I believe in keeping our providers informed every step of the way. Regular updates, even just a quick email or call, can make a world of difference. It’s about respecting their time and ensuring they know we’re on top of things.

By staying transparent, we’re not just preventing frustrations but also showing our new hires that we value them as professionals. It’s a simple but powerful way to build trust and ensure they feel confident and supported as they transition into their new role.

Making Credentialing Part of Their Training

Here’s where we can make a difference—let’s stop treating credentialing as a behind-the-scenes process and start making it part of the bigger picture. By integrating credentialing into our organizational training and compliance programs, we’re not just checking a box; we’re empowering our providers to fully understand their role within the practice.

When they get why credentialing matters—not just what’s happening but the why behind it—they’re more engaged, more committed, and better prepared to deliver top-notch care. And let’s face it, that’s what we’re all aiming for, right?

The Documents and Process: Keeping Everything Up to Date

Credentialing isn’t a one-and-done deal—it’s an ongoing process that requires careful attention to detail. This includes maintaining accurate and up-to-date information across several key platforms: CAQH, NPPES, and PECOS. Let me break these down:

• CAQH (Council for Affordable Quality Healthcare): Most health plans use this database to gather information about providers. Updating this profile ensures that your credentials are current and accessible to payers.
• NPPES (National Plan and Provider Enumeration System): This is where your NPI (National Provider Identifier) is registered. Any changes in your practice location, name, or contact information must be updated here to avoid issues with claims and payments.
• PECOS (Provider Enrollment, Chain, and Ownership System): Medicare uses this system to enroll providers. Keeping your PECOS record up to date is crucial for maintaining your ability to bill Medicare and ensure timely reimbursement.

But here’s the kicker—this maintenance process isn’t something the credentialing team can do alone. Sometimes, additional forms or approvals are required directly from the provider. This is where open communication becomes critical. If we need you to fill out or approve something, we’ll reach out promptly and provide clear instructions on what’s needed and why.

Staying on top of these details is essential, not just for compliance, but for avoiding any disruptions in your ability to provide care. And let’s not forget about recredentialing—this is the periodic process of verifying that your credentials remain up to date and valid. It’s necessary to ensure that everything is in order and that your practice can continue running smoothly.

Putting It into Practice

So, how do we bring this all together? Start with that onboarding call—make it a priority. Use it to set clear expectations, establish open communication, and build a connection. Then, keep those lines of communication open with regular updates throughout the credentialing process.

And don’t stop there—integrate credentialing education into your broader training and compliance programs. Make sure your providers understand not just the steps they’re taking but also why each one matters.

By taking these steps, we’re not just onboarding new hires but making them feel like a crucial part of our team from day one. And that’s how we set everyone up for success.