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Hi there! Yes! Every state’s Medicaid plan has their own fee schedule and you should be able to find it on their website. Thanks for watching!

@@sohailabbas3419 thank you for supporting my channel. Unfortunately, I am not familiar with any IPAs in NY. They are usually very regional and I have not worked with many practices in NY. Good luck!

Hi there and good for you! How exciting. Every employer looking to higher billers and coders call their positions something different. Most want at least a billing and/or coding certification or experience equivalent. I would recommend looking for a job to work a front office position or assist an existing experienced biller to gain the foundational knowledge needed to build from in the industry. Understanding insurances, terminology, the revenue cycle as a whole is pertinent to success. Good luck!

Thanks

​@@navigatingthebusinessofmed8251I have learnt a lot from you

@@Bfaraj85 thank you so much! I appreciate the kind words and support!

There is a lot of phone time, yes and also screen time with looking up information and communicating with insurances electronically too.

@@gloriasadcopon7060 Credentialing applications are generally only for individuals and all education and employment information is needed. There is a whole slew of information and documentation needed. I offer a Credentialing and Contracting course that reviews all of this. I encourage you to see if the lessons will help you further- check out navigatingthebusinessofmedicine.thinkific.com/

@@xmenronny4686 hi and thank you for watching! Yes, they can be proceeded on any machine or portal where you can enter credit card information manually. Great question and I appreciate your support!

@@navigatingthebusinessofmed8251 Can they be used outside Usa? for some instance my Doctor wants to withdraw this money from the card outside usa will these cards works?

@@xmenronny4686 I honestly have no idea as I have never had a provider try to process the cards outside the US. I’m sure there would be additional fees if it does go through, but it’s best to process in the country and then the deposited funds from the payment into the bank account could then be withdrawn. I’m not really understanding the need to process the credit card payment outside the practice.

Thanks for the information. My doubts are clear. 1 last question, Credit card terminal should belongs to Same doctor Practice or it can be withdrawn to any credit card terminal in usa?

@@xmenronny4686 it would need to be set up by the practice for their business so the funds go into their bank account. There are multiple merchant services out there and usually an EMR will have preferred vendors that work with their system.

Hi and thank you for watching my videos. If you cannot find a copy of the contracts from when your provider/group first signed the contract then you need to contact each credentialing department at every payer and ask the send you a copy of your executed contract. They will also be able to provide you the reimbursement information, but the contracts should have that information too. Good luck!

Glad it was helpful!

Thank you!

Thank you for reaching out. I have responded to your email.

Thanks for watching!

@@navigatingthebusinessofmed8251 is there any contact number or email to reach out to you?

@@raza745 thank you!

@@zahoorullahminhas8533 you are very welcome! I appreciate the support!

Hi and thank you for watching! Unfortunately, Medicare does not negotiate their rates, especially with small practices and groups. Their fee schedule is their final reimbursement. You can try contacting your Medicare Administrator Contractor (MAC) to see if they offer any other options, but I have never seen anyone be successful. Good luck!

If you are referring to starting a Credentialing and Contracting business, it should not be too competitive. The key is marketing yourself effectively so medical providers and groups know you are out there. However, the challenge is being able to make money only offering credentialing and contracting services. Credentialing takes a lot of time, so it is very difficult to make it a profitable business by only offering these services unless you charge a high rate that people are willing to pay. That is why many credentialing and contracting businesses also offer other services, or require you to use them as their billing company as well. If you are new to credentialing, I do offer a Credentialing and Contracting course to teach the fundamentals of the job. You can find it here: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialing-and-contracting Good luck and thank you for watching!

Yes, you are correct that Tricare for Life is a secondary insurance to Medicare and Medicare will automatically forward claims to TFL. However, providers and groups still have to enroll/certify with the insurance itself. Tricare East has a separate enrollment with Humana as they administer that region and Tricare West has a separate enrollment with Health Net because they administer the plans for that region. The application in the video shows it is a Tricare for Life specific enrollment form and website. Providers still have to be approved in order to have claims paid. Patients/Members do not have to separately enroll for Tricare for Life. They only need their Medicare card and military identification for billing. I am thinking this may be where you are getting confused. I appreciate you watching my channel and commenting! Have a great day!!

@@7kowskis I’m happy to train your front office. I’m going to start working on a front office course for employers to use for their front desk staff, but that will not be completed until the mid to late fall. You’re welcome to email me jennifer@icsolns.net if you’d like to discuss further. Thank you for your support and watching my videos!

@@annepeltier316 hi there and thank you for your question. You need to reassign the provider to your new group on the PECOS website. This is assuming the provider is already enrolled with Medicare and practicing elsewhere. If they are brand new, then you would need to enroll the provider as an individual and assign them to the group. I hope this helps and good luck!

Thank you! I appreciate the support.

Thanks

I’m sorry to hear this, but unfortunately it is a reality anymore. I wish you the best and thank you for watching and commenting!

Thanks for watching!

Hi there- you need to use the PECOS website to get the group enrolled then reassign all providers who will be working there under that group once approved. This is assuming the provider is already credentialed individually with Medicare. I encourage you to watch my videos on PECOS and other RUclips videos on other channels. Good luck!

Hi and I apologize for the delayed response. I encourage all practices (large and small) to hire an in-house billing specialist to work the entire revenue cycle and help the billing company with what they will need (if a third-party company is hired for billing). It is rare to find a billing company that does everything for revenue management and often needs someone at the practice to work with them and assist. This is also a good idea for someone closely monitoring the account and ensuring everything is being worked and getting done that is expected without much delay. Sometimes if the billing company is very thorough and does most, then a staff member in the practice will do this and have other duties to help lower overheads since cross-training is imperative in a smaller practice. I hope this helps. Thanks for watching!!

Thanks for watching!

Hi there and thanks for watching! Yes they should know and communicate this to current and future employees, but maybe they don’t know. There are also some situations that are an exception to the new rule so that is something to consider as well. I definitely think it is reasonable to discuss it with them before signing anything. I appreciate the support!

I had a feeling there will be ways around this for sure. I appreciate your information.

Hi there and thank you so much for your question. I was hoping you could provide a little bit more information about the type of business that you have and why they’re requiring this. Are you a supplier of some sort? I am not familiar with this, so I am guessing it has something to do with a situation I have never Had the pleasure of working with Medicare on.

Hi there and thank you for watching. I’m sorry to hear of the struggles you’re experiencing. CAQH is used by insurance companies when getting providers credentialed. Not all companies use it. To be referred by an insurance company to your business, you first need to be contracted as an organization with each insurance company and then they will put your providers and group in their online directory under your specialty and address. For other referrals from colleagues, you would need to market yourself to other groups in your area so they know about you and your services. Good luck!

Glad to hear that. Thank you for watching!

Hi there and thank you for watching. You can find multiple places that offer the new required training for free. If he belongs to the AMA/OMA or to your local state medical association they should have that available to him. I recommend Googling “free required DEA training course” to find one if he doesn’t belong to any of the associations mentioned above. Many will also provide CEU/CMEs for taking the course as well. Good luck!

Glad it was helpful! Thank you for watching!

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Hi there! Great job on what you’ve done so far. Medicare is really not that difficult if you know the steps. Unfortunately my course does not go into step-by-step for Medicare. The first step is getting permission in the I&A portal to work on behalf of the group and providers you need to credential/reassign for Medicare. You need to create your own log-in to access I&A. There are instructions on that website that to help you. When completed and you’re a user, you need to make sure they grant you permissions in PECOS specifically when they authorize you under their own accounts. Your credentials work in I&A, NPPES and PECOS (Medicare). Good luck!

@@navigatingthebusinessofmed8251 Thank you!!

@@navigatingthebusinessofmed8251 I am thinking about taking the Credentialing Specialist course in AAPC to get the certificate. I still haven't started Medicare yet, its my next project to learn. Thank you for the advice above.

Hi Doctor and thank you for watching. Unfortunately, I am not aware if this is possible or where to look for that information since technically (my understanding is) it is “illegal” for patients to import medications from outside the country with the exception of a few circumstances. I’m sorry I can’t offer further assistance.

Hi there and thank you for watching! Aetna, in my experience, has also been a challenging insurance to escalate issues. I’ve been known to call their claims department, or another department and ask for a supervisor. I have also asked to see if they have an alternative contact method or email address/phone number to try. I can’t say I’ve always been successful but I do try other avenues to see if someone can help get me there. I’m sorry you’re experiencing that, but you’re not alone. Good luck!

@@navigatingthebusinessofmed8251 ok. I will see what I can do. Actually, I have a successful negotiation on few of CPTs and the rep said that she was building the contract and now she is not responding. This was happening from last 3 months. I hope I can get a response. Thanks for your prompt response. Really appreciate your help.

Thank you for inquiring, but at this time I am focusing on consulting for medical practices only. I do offer a credentialing course to train people about the Credentialing and contracting process and that may help you. The link is in the video description and there is a QR code to scan in the beginning of many of my newer videos too. Good luck!

I’m so happy to hear that! Thank you for your support!!

It really depends on if you’ll be prescribing a lot of controlled medications or not and the state you work. Since DEA registrations are ran state to state, yours may have different requirements for the provisional license. Your local medical board should be able to provide more information for you to determine what is best for your situation. Thanks for watching!

Thank you for your question. Yes, I do offer consulting services. Please email me directly at jennifer@icsolns.net. I appreciate you watching my videos!

@@navigatingthebusinessofmed8251 Just sent you an email!

Hi there and thanks for watching! This can be challenging depending on your payer mix and also your specialty. A good goal is to have a set number of “preventive” type visits each month as those tend to not go to patient responsibility and insurance pays. Of course, the patient would need to be due for such services per their plan benefits and based on the last time they had a similar visit or are age appropriate. More than anything, sending out clean claims the first time and following your payer guidelines is going to be key to successful cash flow in the practice. This also means checking patient’s benefits and eligibility before patients are seen too. This will ensure you’re participating with their insurance and you can collect any copays at time of service. If you choose to do a deposit for patients with high-deductible plans, this allows for some financial stability too. Practices just need to have very rigid guidelines and check payer contracts that it is okay to that for their beneficiaries. I hope this helps- I could talk all day on this and I think I found a topic for a future video! Thanks so much!!

@@navigatingthebusinessofmed8251 Thank you! Does this apply to the traditional fee for service environment or would this apply just as equally under a value based care bundled payment option ?

@@Anubis0680 this would mostly be for FFS model since quantity plays a major factor. However, coding and submitting clean claims still apply for both VBC and FFS. VBC sees more bundling of services for set fees so this would make it a bit easier to have goals and anticipate monthly income.

I’m glad you found it helpful! Thanks for watching!

Thank you for watching and agreeing!

It’s so nice to hear from you! I definitely noticed your absence. I’m excited to hear about your new adventure. DME is a whole other world of medicine and hoops to jump through, especially for Medicare. You’ll learn a lot and be great, I’m sure! Thank you for continued support and kind comments. I appreciate your insights.

Hi and thank you for watching my channel. I have a whole playlist centered around Credentialing and contracting with specific Medicare and Medicaid ones. If you are already an established group with payer contracts, you will need to check with your contracts and/or payer portals on how each require you to add a provider to your group contract. For Medicare, you need to reassign them on the PECOS website. The Texas Medicaid site should tell you how to add a provider. Every insurance will check to see if the provider is correctly credentialed and if they are due for re-credentialing before they add them to your group. They will let you know if they need anything else done in the credentialing realm of things. It is important to note that every insurance gives an effective date of when the provider becomes affiliated with the group and you cannot bill out services under that provider until you receive those effective dates and it is after that date or it will either process as out of network or deny if the patient does not have out of network benefits. I hope this helps! Good luck!

Hi there! Your new practice/business will need to be recognized by both Medicare and Medicaid to be considered in-network, even if you plan on billing as a sole proprietor. You will be affiliated to the group as the owner, so if you’re due for recredentialing then they will tell you. I hope this helps and good luck!