Author Topic: How do providers register with insurance companies?  (Read 1602 times)

Michele

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How do providers register with insurance companies?
« on: March 08, 2008, 07:27:43 PM »
Question
Hi Alice!
How are you and everyone there? Hope you are doing well with your
business.
Could you please explain me the following:
 
In USA does a Doctor(PROVIDER)require any registration with all the
Insurance companies to claim for his medicall bills? or is there any
other procedure they have, to claim for the medical bills? Please tell
me about this.
Note: Kindly don't foget me if you have excess work of medical
billing. If you can give me at least one provider that would be a great
help.
 
Thanking you,
Sincerely
Jagdish.

Answer
Hi Jagdish,
 
 Things are going well here.  Hope it is the same for you.
 
 Here the doctors must fill out an application for each insurance
 company that they want to participate with and then get accepted by
 that insurance company.  If they apply and are accepted, they are
 considered "in network"
 and are paid at the rate they accepted when they applied.
 
 There is also a universal credentialing system called CAQH.  Here's
 more information about CAQH
 http://www.solutions-medical-billing.com/caqh.html
 
Hope this helps.
Alice
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dc006

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TSCA vs. C A Q H application
« Reply #1 on: August 24, 2009, 01:52:25 PM »
Hi Alice and Michele:

As a new credentialing service in Texas, I have discovered that most hospitals ask for the TSCA to be completed along with the hospital's paperwork.  It is required by the Texas Insurance Board, but the State does not keep a copy of it for the provider.  Therefore, each time a provider seeks privileges at a different hospital, a new TSCA has to be completed, requested from the previous hospital, or a copy kept especially, if they are a new client.  And, it has to be no more than two years old.   I have had only one insurance carrier ask for the CAQH application to be completed for a provider.

Can the CAQH be used in conjunction with the TSCA or instead of the TSCA for a hospital or insurance company?  Both have a great deal to complete.

Thank you.

Denise

Michele

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Re: How do providers register with insurance companies?
« Reply #2 on: August 25, 2009, 07:06:59 AM »
Denise,
    I have not heard of the TSCA form before.  Is it specific to Texas?  Most of the major carriers utilize CAQH and I have never had them ask for a TSCA.

Sorry  ???

Michele
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