Managed healthcare in today's world seems to be leaning in favor of the insurance carriers, not the provider or patient. Patients are not allowed to see the doctor of their choice unless the doctor is in their network. Providers are not allowed to join those networks because the insurance carriers state their "panels" are full in the doctor's geographic area. If you search the provider directories posted on the internet, a lot of the doctors that are listed "in network" have moved to different areas or have even expired or have retired from practicing. Many healthcare professionals are being turned away from network participation for no viable reason. Some states have a "any willing provider" law that allows any provider to belong to any provider network if they choose. Unfortunately, there are more states than not that do not embrace this law. Outsourcing this task is extremely beneficial to a medical practice. The time spent in preparing complete credentialing packages is so critical to the acceptance of providers and most offices don't have the time to prepare these packages. Also, more times than not, the providers do not send in the correct information needed to get him/her credentialed and in participating status with insurance carriers. Providers that attempt to operate a cash practice are taking a huge risk. In today's healthcare world, it is almost imperative that doctors are participating in medical insurance plans, for their businesses to survive. |
