Credentialing services

Understanding Common Practice & Credentialing Terminology

Ever have a conversation with someone who starts spouting off acronyms or terms and you have to pretend you know what they’re actually saying or risk looking like an idiot.  Well, before Google, most of us were there a lot more often than we’d like to admit. We’ve put together this helpful article on credentialing […]

practice start-up checklist

Step-By-Step Practice Start-Up Guide & Checklist

Our comprehensive practice start up guide and checklist are available for free to anyone considering starting a new practice. These resources will provide you with a roadmap and timeline to get your practice started on a firm foundation.

where to open a new medical practice

How to Select the Best Location for your New Medical Practice

As we all know, selecting the right location for your new medical practice is critical to your success and long-term growth.  We’ve literally opened hundreds of medical practices over the years and while most have been successful, there have been a few occasions where the practice has failed after a couple years. We are happy to provide this comprehensive location analysis to help you select the best location for your new practice.

aco administrative services

How to Register with CAQH & Why it Matters to Your Practice

CAQH is ubiquitous in the medical field these days but there are still a lot of misconceptions about what it is and what it does. This article will answer all of your questions about why, when, how and what as it relates to CAQH.

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 Fee Schedule Search Tool

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.