We are in the process of compiling last year’s credentialing data for a report on the average processing time for the top six insurers. The report will include state or region specific information that will be broken down by insurers. It will be from the first day that we contacted the insurance company to begin the process. These insurance companies may not be the top payers in your area but nationwide they represent the majority.
Archive for Physician Credentialing Service
Insurance Credentialing For New Healthcare Practices
Time and again new practices invest countless hours and money focused on office space, equipment, software and staffing only to open their doors for business and find significant delays in getting adequate insurance reimbursements. More often than not, the problem could have been allayed by addressing the insurance credentialing process early and thoroughly creating the necessary relationships with insurance carriers. Here are a few considerations to keep in mind as you address the insurance credentialing process.
Timing Start Early!
Physician Credentialing in your State
If you are considering opening an office or adding a provider, we can help. Even if you chose to do it on your own, we would be happy to give you some important tips to make the process less painful. We only caution physicians to give yourself ample time and make sure that you are very diligent in responding to all requests for information.
We typically have our physicians on all necessary panels within 90-120 days of our engagement. We do more than just credential but actually negotiate with the payers and work to obtain the best rates possible. As part of our credentialing service, you receive custom fee schedules that indicate how you will be paid as a percentage of Medicare from all payers for your top 15-20 cpt codes.
Nurse Practitioner & Physician Assistant Credentialing Services
We offer discounted services for clients who need us to credential their Nurse Practitioner or Physician Assistant with Medicare, NPI, and Commercial Carriers. There are many reasons to hire a Nurse Practitioner or Physician Assistant and there are numerous excellent non physician providers who are looking for the right opportunity.
We will set up the NPP (non physician provider) with their NPI number, CAQH id, Medicare number, and with all applicable commercial carriers. It is important that the NPP go through the necessary credentialing process so you can accurately bill for their services and maintain compliance regarding “Incident to” or NPP billing. Most carriers require you to credential the provider under your contracts and some carriers like Medicare and Tricare provide the NPP with their own number.
New Practice Start Up Questions
Feel free to post any questions related to opening a new practice and we will be happy to help. Credentialing and starting a new practice is a major headache so don’t try to go it alone. Please utilize the Practice Forum for free assistance.
We welcome your credentialing, insurance or practice start-up questions and would be happy to assist you. Starting a medical practice is one of the most difficult things a physician could ever do. It is unfortunate, but most medical programs do not provide physicians with the necessary training to start a practice effectively.
Step by Step Credentialing
There is no easy way to credential new associates but we hope to provide you with information to make it as painless as possible. Coming soon will be a step by step guide that will help you understand the credentialing process and the pitfalls involved. Our credentialing walks you through the process and gets your organization on the insurance panels in no time.
States where Credentialing Services are offered
We offer credentialing services to practices and surgery centers in most of the 50 states. Our managed care team have credentialed hundreds of physicians and will quickly assist you with your contracting and renegotiation needs. We have current and previous clients in these states. We can quickly access your market and get you on all available plans that are worth participating. With the current economy, most of our clients simply want the patients and are willing to take a little less than Medicare if that is what the payors offer. We never accept less than 95% of Medicare from payors unless our client absolutely needs to participate in a certain network.
Medicare Credentialing
I don’t know of anything currently that has caused more practices to go out of business than an improperly completed Medicare application. Whether it is an 855i, 855b or 855r, we have cleaned up more messes from practices trying to take physician credentialing into their own hands, especially, when it comes to Medicare.
With the ever changing Medicare rules and regulations, it is important to choose a company that has experience in Physician Credentialing on all levels. Medicare credentialing is one of the most difficult parts in any credentialing and you cannot afford to make a mistake. A mistake in your Medicare applications will result in payment delays and lost revenue.
Physician Credentialing Headaches
Physician credentialing has never been more difficult and with the declining reimbursements and increasing costs physicians everywhere are feeling the burden and looking for ways to streamline their office. One thing to help physicians accomplish this is to outsource their credentialing requirements.
Credentialing is a very time consuming part of any office and requires significant labor involvement. Credentialing with Medicare and all managed care contracts takes significant effort on the part of your staff
