Credentialing Process:
Credentialing includes a review / registering a doctor’s completed education, training, residency and licenses with any certifications issued by a board in the doctor’s area of speciality.
This is definitely a time-consuming process, and often takes up to six months to complete. The reason for the lengthy process is the requirement for submission of extensive background information.
In the past, each provider had to be individually credentialed with each individual health insurance plan. For some, this is still the case. Many health insurance companies, however, are now using a centralised database.
Who does not need to be credentialed?
- Physicians billing under another provider’s number (locum tenens).
- Urgent Care providers seeing only commercial insured’s (not govt) (may vary state).
- Facility-based providers (R.A.P.E. – Radiology, Anaesthesiology, Pathology & Emergency medicine).
- Self-Pay practice physicians”Concierge” medicine.
How is it done?
WWS team of Credential Experts enrolls or credentials hundreds of providers every year with insurance plans across the country.
Whether it is Medicare, Medicaid, the various commercial insurance plans, or even the various worker’s compensation networks, our team of credentialing experts have decades of experience and will ensure your practice receives the care and attention it deserves.
Steps for Streamlining Provider Credentialing Process:
- Developing an integrated approach to provider credentialing:
- Make provider enrolment an integral part of the revenue cycle program.
- Avoid credentialing and provider enrolment mishaps.
- Enhance credentialing process with KPIs.
- To Know More On How Credentialing & Contracting Can Be Less Time Consuming and More Effective More @ https://wonderws.com/credentialing-contracting/