Author Topic: Credentialing for a new group  (Read 1932 times)

Oscar12

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Credentialing for a new group
« on: February 09, 2016, 12:22:28 PM »
I am trying to credential a new provider group; we will have an MD and a licensed counselor to start.  Both providers will be working for us part time and will continue to practice for other groups.  Both are on the panels of most insurance companies.  I understand the process for Medicare and Medicaid, but am confused about the private carriers (Anthem, Aetna, UHC etc).  They keep telling me that the individual providers must apply and then the group process will kick in and seem to ignore that these people are already on their panels.  Should I be looking to add the group to the individual provider's records with these companies?

I would appreciate any insight, and thank you for the help.

Michele

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Re: Credentialing for a new group
« Reply #1 on: February 10, 2016, 02:42:53 PM »
Actually you should be connecting the individual to the group.  The individuals can still keep all previous links.  If the group is not established with the insurance carrier then they may start with the individual who is already credentialed and add the group from there.  You need to contact each commercial carrier and ask them what you need to submit to get this accomplished.

Good luck!
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Oscar12

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Re: Credentialing for a new group
« Reply #2 on: February 11, 2016, 01:15:21 PM »
Thank you--I will try talking to those folks again.

Medical Billing Forum

Re: Credentialing for a new group
« Reply #2 on: February 11, 2016, 01:15:21 PM »