Telehealth has been on the rise for several years, but the COVID-19 pandemic has accelerated its adoption and highlighted its importance in providing timely and accessible healthcare to patients. While telehealth offers many benefits to patients and providers, it also comes with its own set of challenges. One of the most significant of these challenges is timely credentialing and enrollment for telehealth providers.
Benefits of Telehealth Services
Due to its many advantages, telehealth, or the provision of healthcare services via telecommunication technologies, has gained popularity over time. Increased access to care is among the most important benefits of telehealth, especially for patients who reside in rural or underserved locations.
Telehealth gives patients the convenience to obtain treatment in the comfort of their own homes. Furthermore, telehealth has the potential to be less expensive than in-person care, saving money on healthcare for both patients and providers.
The need for telehealth services has increased dramatically in the wake of the COVID-19 outbreak. Many patients chose telehealth as a secure and practical means of receiving care in the face of social isolation policies and orders to remain at home.
Although telehealth presents numerous advantages for both patients and providers, it also poses unique challenges that must be addressed. These challenges are listed are given below:
Challenges of Credentialing & Enrollment for Telehealth Providers
Credentialing and enrollment can be a complicated and time-consuming process for any healthcare provider, but it can be even more challenging for telehealth providers. Here are six challenges that telehealth providers may face when going through the credentialing and enrollment process:
- Licensure Requirements: Each state has its own licensure requirements, and telehealth providers must be licensed in the state where the patient is receiving care. This can be a time-consuming and expensive process, as providers may need to apply for multiple licenses.
- Technical Requirements: To offer telehealth services, telehealth providers must have the required technology infrastructure, including secure video conferencing software, electronic medical records (EMRs), and HIPAA-compliant communication tools. Health plans could demand that telehealth service providers produce proof that they have the required technologies.
- Documentation Requirements: Telehealth providers must provide a wide range of documentation to complete the credentialing and enrollment process, including proof of malpractice insurance, education and training records, and professional references. This can be a time-consuming process, especially if providers do not have all the necessary documentation on hand.
- Delays in Approval: The credentialing and enrollment process can be lengthy, and health plans may take several weeks or even months to approve an application. This can lead to significant delays in getting reimbursed for services and may discourage providers from offering telehealth services.
- Changing Regulations: Rules are continuously changing, and it can be difficult for providers to stay on top of the most recent needs. Providers of telehealth services would need to alter their business procedures and technological infrastructure to comply with various health plans’ standards.
- Credentialing and Enrollment Staffing: Many health plans have limited staff to handle the credentialing and enrollment process, and the staff may be overwhelmed with the volume of applications they receive. This can lead to further delays in the credentialing and enrollment process, which can impact patient care and provider reimbursement.
Strategies for Telehealth Providers to Help Expedite the Credentialing and Enrollment Process
Credentialing and enrollment can be a time-consuming and complicated process for telehealth providers, but there are strategies and tips that can help to expedite the process. Here are some of the top strategies that telehealth providers can use to help streamline their credentialing and enrollment process:
- Research Health Plans: Telehealth providers should research health plans in their state to determine which ones offer telehealth coverage and their requirements for credentialing and enrollment. This will help providers understand each health plan’s specific requirements and tailor their applications accordingly.
- Keep Documentation Up-to-Date: Telehealth providers should keep their documentation up-to-date, including their medical licenses, malpractice insurance, and professional references. Providers can keep all of their documentation in one place and update it regularly to ensure that they are prepared for the credentialing and enrollment process.
- Use a Credentialing Service: To assist with managing the enrollment and credentialing processes, telehealth providers might make use of a credentialing service. These services can aid providers in completing the application process, gathering, and organizing the required paperwork, and navigating the process in general. This can shorten the process and save the provider’s time.
- Use Technology to Simplify the Process: Telehealth providers can make use of technology to simplify the enrollment and credentialing processes. To maintain their documentation and submit applications to health insurers, for instance, providers can use an electronic credentialing system. Providers can speed up the procedure by using telehealth software that has already been authorized by health plans.
- Network with Other Providers: Telehealth providers can network with other providers in their state who have gone through the credentialing and enrollment process. This can help providers to learn about the specific requirements of health plans, get tips for expediting the process, and build relationships with other providers in the telehealth community.
- Be Persistent: Finally, telehealth providers should be persistent when going through the credentialing and enrollment process. Providers should follow up regularly with health plans to check on the status of their application and address any concerns or questions that may arise. This can help to keep the process moving forward and ensure that providers are able to offer telehealth services to their patients in a timely manner.
Telehealth providers who want to provide their services to patients in a fast and effective manner, prompt credentialing and enrollment are essential. Despite the complexity and difficulty of the credentialing and enrollment process, there are steps that providers can take to speed up the procedure. Telehealth providers are able to give care to all their patients regardless of where they live. Timely credentialing and enrollment will be increasingly crucial as telemedicine continues to gain popularity, and providers that can shorten the process will be better positioned to satisfy the demands of their patients and succeed in the telehealth industry.
- American Telemedicine Association: ATA’s Provider Telehealth Engagement Model – ATA (americantelemed.org)
- Telehealth HHS: What is telehealth? | Telehealth.HHS.gov
- National Committee for Quality Assurance: “COVID, Telehealth & Quality”: Wow, What a Webinar! – NCQA
- Association of American Medical Colleges: Telehealth Competencies | AAMC