The Not-So-Hidden Cost of Slow Provider Onboarding and Enrollment

The Not-So-Hidden Cost of Slow Provider Onboarding and Enrollment

Dec 12, 2018

By: Lance Hebert, VerityStream’s VP of Ambulatory and Post-Acute


No business can survive without revenue. That’s as true of a medical practice as it is of a grocery store or florist’s shop. Unlike those businesses, however, a healthcare entity must carefully vet and screen its employees, most notably its doctors, as well as provide outstanding care and service. And if it doesn't do the former, then it’s in trouble no matter how good the latter is.


Comprehensive and thorough provider enrollment are where it all starts in terms of a practice’s revenue cycle. A spotty, thinly staffed or sluggish setup on your end can cause serious financial damage in many ways: slow reimbursements, write-offs, and denials, just for starters.


Healthcare systems and medical groups, whether affiliated or independent, have begun to realize that when it comes to provider onboarding time is literally money. At the same time, the provider onboarding and enrollment process has never been more complicated and cumbersome, especially around insurance-network participation. VerityStream’s 2018 Provider Enrollment Survey revealed that in stark terms:


  • More than 40 percent of providers are enrolled in between 10 and 19 commercial health insurance networks or plans
  • The number of providers enrolled in 10-20 health plans was 43 percent, a 5 percent uptick from 2017

Now consider this example to see how a robust, automated onboarding system can ease that burden and recapture potentially lost revenue:


If the opportunity cost per day for one doctor is $6,641 per day (per the 2016 Merritt Hawkins’ Physician Inpatient/Outpatient Revenue Survey), and the practice is bringing in 30 new doctors, that’s $199,230 in potential daily revenue. Potential, because it’s not coming in if those doctors aren’t enrolled and billing insurance networks and plans.


Now imagine an onboarding solution that captures their information quickly, reduces duplicate effort, cuts errors significantly and gets those physicians enrolled and billing 15 days quicker than your current setup. The result?


Revenue gain = $2,290,950


The onboarding enrollment task isn’t going away, so isn’t it time to look at a fast, thorough, easy to use and carefully vetted process that ensures success and speeds up the revenue stream?


Turning challenges into easily completed tasks


How best to realize a solution, then? Start with the paperwork. Those who tasked with provider enrollment, as well as the providers themselves, list the volume of forms to be completed as their biggest headache. Other challenges include:


  • Collecting the required data from each provider
  • Keeping that data up to date
  • Staying on top of data changes

Accordingly, a solution will:


  • Maintain a current database of forms and make those easily populated and accessible to everyone who needs to offer input and information.
  • Allow for easy review of information to make sure data matches.
  • Provide automated checklists, centralization and updates are essential as well.

Every one of those steps saves onboarding turnaround time, which means practice labor overhead comes down, and payments and reimbursements start flowing more quickly.


The ideal system we’re talking about exists. The above benefits are some of the many key value offerings provided by VerityStream for Medical Groups, which can provide credentialing and related services for physicians and other staff.

Is your enrollment process slowing you down?
How nimble and responsive is the enrollment system that supports your onboarding? Is it performing as quickly and capably as possible? If you’re only reasonably certain that it is, but unsure of where efficiencies could be improved, or where slowdowns are occurring, we are ready and willing to help you with an assessment.