Medical Billing Forum

Starting a Medical Billing Business => Starting Your Own Medical Billing Business => Topic started by: IDTFPro on August 25, 2012, 08:19:26 PM

Title: Medicare Credentialing Services
Post by: IDTFPro on August 25, 2012, 08:19:26 PM
I am currently working in the Provider Enrollment depart for a Medicare carrier, specializing in IDTF enrollment. I've been doing this for several years, but we have lost our contract and the office will be closing in a few months. Once the office closes, I'm interested in doing some Medicare credentialing on the side, but I'm not sure how to go about starting.

Are there enough providers looking for enrollment services only, or are most of the providers looking for enrollment and billing combined? 

Any advice is appreciated.
Title: Re: Medicare Credentialing Services
Post by: PMRNC on August 26, 2012, 12:12:34 PM
JMHO but with all the consulting I do, I'm getting more doctors getting OUT of Medicare/Medicaid rather than getting in.. with Obamacare I expect it to get worse. JMHO.    Also Medicare credentialing is pretty straight forward and probably the easiest.. I can't say you shouldn't do it, but it certainly shouldn't be your only service as there wouldn't be much work.
Title: Re: Medicare Credentialing Services
Post by: Michele on August 27, 2012, 07:01:21 AM
There are a lot of providers looking for the enrollment part only.  They are not always looking for both enrollment and billing.  I too have soon more and more providers looking to "opt out".  I too expect it will continue to get worse.
Title: Re: Medicare Credentialing Services
Post by: themedicalbilling on October 06, 2012, 04:00:21 PM
There are a lot of providers looking for the enrollment part only.  They are not always looking for both enrollment and billing.  I too have soon more and more providers looking to "opt out".  I too expect it will continue to get worse. I totally agree with you admin the basic idea to present your self.
Title: Re: Medicare Credentialing Services
Post by: davidharvey on December 11, 2012, 06:48:41 AM
There are enough providers looking for enrollment services. It is important to make sure that we are going in the right way. To get more solutions and suggestions, we should go through the valuable information to improve our Business.
Title: Re: Medicare Credentialing Services
Post by: PMRNC on December 11, 2012, 07:15:20 AM
Quote
we should go through the valuable information to improve our Business.

The value of enrolling in Medicare? I make it a practice not to lie to my clients. (little joke there) in all seriousness, I've not more opt out's of both Medicare and Medicaid. For Medicaid I usually just go ahead and take the ones out that want to get out but if they are a Medicare provider looking to opt out, I do a complete practice analysis FIRST. There is way too much that goes into credentialing and DE credentialing to just pull a provider our or get them setup with one. There are many variables that go into it, steps that should be taken to determine the health of the practice BEFORE enrollment or opting out.  I very rarely do credentialing w/out other services, I perform practice financial analysis, audit's, policies/procedures, compliance training/staffing,  I can't really remember if I've ever done JUST the credentialing. I have more consulting clients that return to me for one reason or another or on a bi-annual basis than I do billing and it nets more profit for sure. I also don't just do the tier one credentialing, I do contract and fee schedule review and negotiations as well, I either use the provider's attorney to assist me or my own and we split the job. But again there's no straight forward IN or out of most carriers and it's vital to any practice to see how that enrollment or opt out is going to effect their bottom line.  The exception is Medicaid.. if the provider wants out that's great I'll take him out because 90% of the time the practice will MAKE money getting rid of Medicaid, the other 10% needed to first get their marketing of their practice in order because they were too heavily dependent on Medicaid. OR their area dictated they be, in which case they probably should look for another job.  :o