Can you retroactively bill Medicare after credentialing is complete?

medicare enrollment process

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.

How do you credential a provider with an insurance company?

credentialing services

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 […]

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

contract evaluation tools

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.

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

Nurse Practitioner Credentialing Services

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.

What’s the difference between a TRICARE network and non-network provider?

tricare network vs non network provider

What is a network provider with TRICARE? A network provider is a participating “civilian”(not on the base or a military employee) provider who has completed the TRICARE credentialing process and signed an insurance contract with the TRICARE administrator for your region. Once this contract is signed and loaded, a network provider will be loaded into […]

Tricare Prime vs Certified, which is right for your practice?

conversion factor fee schedule tool

We are writing this article to help answer questions we receive on a weekly basis. Most of our clients want/need to see military patients, both retired and active duty, but only a handful of these clients actually understand the difference between becoming certified and actually being contracted. So we’re going to answer the most frequently asked questions here.

Medicare Bank Letter Template

physician credentialing services

If you are completing the enrollment process with Medicare as a new organization, you will need to also complete the EFT enrollment process using form CMS-588.  Medicare requires that you send in a bank letter or voided company check (with the correct address and name displayed) along with the CMS 588