credentialing services

How do you credential a provider with an insurance company?

How Credential a Provider With Insurance Companies Credentialing with insurance companies otherwise known as provider enrollment can be extremely frustrating if you’ve never done it before.  Even with experience and every tool at your disposal, the credentialing process can still be exhausting.  Here is a brief overview of how to complete the provider enrollment or […]

credentialing costs

How much does physician credentialing cost?

How much does physician credentialing cost? How much is credentialing costing your company?  We answer both of these questions in this article.

credentialing services

When does outsourcing your credentialing make sense?

As we all know, healthcare facilities exist to facilitate and administer medical care to their patients. While we have advanced like never before in our cure rates, infection prevention, disease management, OR efficiency and nearly every other available metric, the roadblocks to actually running a successful practice have done nothing but increase in size. Every […]

what is the insurance credentialing process

What is the insurance credentialing process?

The insurance credentialing process is what each provider or facility must go through in order to become a participating provider with a particular insurance company.  The goal of the insurance credentialing process is to become in-network and prevent your patients from having claims go towards their out-of-network deductible.

practice start up services

How much does it cost to start a medical practice?

In this article, we define some of the costs of opening a medical practice. Whether it’s what to spend on equipment or selecting the right billing/EHR vendor, we cover what to expect in terms of cost.

temporary credentialing

How long does it take to start a new private practice?

How long should you give yourself to start your new practice? We answer it here. Before beginning, we recommend setting up your practice as a professional limited liability company(PLLC) that is taxed as an S corp.  This offers you the most protection as an entity and prevents double taxation on dividends.

medicare enrollment process

Utilizing the Medicare Physician Fee Schedule Tool

It’s important for you to know how much you’ll be paid for the services you’re providing.  Many people get confused by their billing system because it will show a charge amount that’s much higher than the actual allowed amount.

medicare enrollment process

Can you retroactively bill Medicare after credentialing is complete?

Retroactively billing Medicare is an important detail to understand due to how long credentialing can often take. Depending on the state, Medicare can take anywhere from 50-150 days to complete the enrollment process.

More Consolidation – Does it really help lower costs?

Cigna acquires Express Scripts for 67 billion, does further consolidation help lower costs or improve service to providers?  We are always hearing about these acquisitions and how they help lower costs but are these savings ever passed to providers in the form of better reimbursements or to the consumers?  I doubt it and would love to see a study that proves me wrong.

contract evaluation tools

What Are We Doing To Our Physicians! Depression & Suicide Increasing

The suicide rate among men who are physicians is 1.41 times higher than the general population of men. For women who are physicians, the relative risk is even higher —- 2.27 times greater than the general population of women.  This is heartbreaking but not surprising.  What’s surprising is that medical training programs are doing very little to address this problem.  Why?  I believe that they been the proverbial Ostrich sticking their heads in the sand in the hope that the problem will pass. With the growing physician shortage crisis, you would think that the medical programs would take more initiative in identifying the warning signs of depression and develop a plan to combat the high risk of suicide.

Nurse Practitioner Credentialing Services

NP Practice Disaster- What Not To Do When Starting a Practice

Don’t let this np practice horror story happen to you. Learn what not to do and ensure your practice is and remains compliant with your state regs.