Common Confusions With Credentialing
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- Опубликовано: 20 окт 2024
- Unfortunately, credentialing in healthcare can be very confusing and sometimes leads people down some windy and frustrating paths. This video explains the three most common confusions and how to avoid them when you need to be credentialed for your new practice.
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ABOUT MY CHANNEL:
Hi! I’m Jennifer. After working in the medical field, in many different capacities over the last 15 years, I have learned much about where medical practice owners go wrong in running their businesses. I created this channel to try and assist medical practice owners from making the same mistakes as their colleagues. I want to see the private practice world of medicine grow and thrive. In my opinion, medicine has become too institutionalized, creating a lot of unnecessary obstacles and demands.
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THANK YOU IVE BEEN "SELF / GOOGLE" LEARNING OVER THE PAST 10-YEARS. WISH I HAD YOUR VIDEOS BACK THEN. I LOVE LEARNING ABOUT INSURANCE AND CREDENTIALING IS VERY EYE OPENING AND SOMETHING MOST PPL DONT REALIZE WHAT I CALL THE SILENT OR BEHIND THE SCENE POSITION. IT'S BECOME A FULL TIME POSITION SINCE THE PRACTICE I WORK AT TAKES 40+ PLANS [DENTAL INSURANCE]. SO THANK YOU FOR THE REFRESHER.
I’m so happy to hear you find the information helpful! Good for you to be self-taught! It’s not easy. I appreciate you supporting my channel. Be well.
This is great information.
Glad you think so! Thank you for the support!
Hi Jennifer, thank you for your precious time and kind hearted for making these informative, headache-solving videos. My husband and I will open our practice soon, and by watching your videos, we learn a lot. I have a question, if you have an answer to guide me. My husband (provide) is still working in his company until end of May. Can I strat a credentialing process with our new practice while he is still in his job? Thank you.
Thank you for the kind words! I’m happy to hear you have found them helpful. Yes, start ASAP because he cannot start really seeing patients until he is credentialed and it takes at least 30 days, but closer to 90 with many payers. Sooner the better. Hopefully you already have the business address. You can email me jennifer@icsolns.net too. Good luck!
Hi Jennifer ! I’m so happy I found you. I’m in the process to credential my provider with his own private practice. My provider will still be associated and working with the group currently. How can I get started on getting him credentialed. Already have Location , EIN and NPI type 2 for the practice but what do I do now ? I attempted to start with Medicaid and medicare but when I go to medicare application online I can’t proceed the part where I enter the licensing information? I would appreciate your help 🫶🏽😭💗 Ty again for your videos
Hi there and thank you for watching! If the provider is starting their own group, you first must get the group approved by Medicare before you can associate the provider with it. The first step with Medicare is getting the group application submitted. For other payers, you may be able to submit the registration for the group while simultaneously affiliating the provider with this new group. It all just depends on the payer and their process. I suggest looking at payer websites, or calling them, to find out what they require in the process. By doing this you will not remove the provider from their existing employer group unless you specifically ask for that. They should still be able to work at existing places until the new group contract is executed and they can start working under their own business. I hope this helps!
What if you have a midlevel that works part time with your practice and then part time with another practice? Can you be associated with 2 practices in a separate contracts?
Yes, you absolutely can do that. The provider would just have their individual NPI (NPI 1) listed under each group's contract in which they work so when they bill out under themselves at each entity, it is processed under that entity. All claims have the entity's billing information with NPI 2 and TIN and then the rendering provider's NPI 1 and they would need to be tied together that the insurance company to work that way. They would operate individual of one another.