Medical Credentialing: Overview and Tips for the Insurance Credentialing Process
Today, Medical Credentialing is a valuable part of starting or building a private practice. In fact, even many veteran health providers, who've had successful cash-only private practices for decade or maybe more, are clamoring to start or complete the entire process of medical credentialing (which is, these are working quickly to have on insurance panels).
This change has happened quickly, as universal healthcare has had root in some aspects of the USA (like in Massachusetts) how to write a letter to insurance company and definately will soon be nationwide. In addition, over just a few short years, the attitudes of patients (or clients) is different.
In the not so distant past, clients / patients were willing to spend of pocket for services rendered by therapists, counselors as well as other mental health providers. In contrast, clients today expect-and demand-that their counselor will be able to accept their insurance. Hence, if counselors wouldn't like to turn potential new patients away, they need to be credentialed with insurance firms.
While medical credentialing will most likely never become your favorite pastime, there are many items you can keep in mind that can make the method easier.
1) Expect to devote about 10 hours for each insurance panel you intend to be credentialed with.
Expecting that credentialing is going to involve just a couple minutes of filling out a credit application will lead just to frustration. Instead, expect 10 hours of focused labor per company you need to be credentialed with. This time will include retrieving applications, filling our applications, organizing necessary documentation, and following with insurance firms by telephone.
2) Follow with the insurance provider often.
Insurance companies use a way of losing provider applications, or putting them in "limbo"-where these are not being reviewed properly and the medical credentialing process goes nowhere. The problem with credentialing application "limbo" is that if a credit application is stuck there for more than a month or so, it will expire and be automatically rejected, leaving the provider (that's you) without having option but to start again, from the first task. Hence, you should call each insurance provider each and every time a credit application (or any documentation) is faxed, emailed, or mailed for them. After that, you should call every insurance provider about every fourteen days, to test up on the status in your credentialing applications.
3) Consider getting medical credentialing help
For many medical researchers, commemorate pragmatic sense to identify a reputable intend to benefit credentialing. Not only does employing a medical credentialing service alleviate the frustration and headache of the method (many providers be familiar with the 'nightmare' stories from their colleagues), employing a service might also save money, and a reputable service will more than likely have better success getting you credentialed efficiently-meaning you can start seeing those clients with insurance sooner, instead of later.
Comments