Author Topic: Enrollment Question  (Read 1822 times)

Matty

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Enrollment Question
« on: May 10, 2013, 04:46:33 PM »
Hi, I am new to this and wanted to see how many companies offer Insurance Enrollment as a part of their standard rate?  Our company is growing faster than it seems we can keep up sometimes but we have started offering Enrollment as a part of the package, so to speak.  We collect a percent of payments from our clients like most companies do but besides our Start Up Fee we have no additional charges passed on to our clients.  Anyway I was just curious of how many companies include Enrollment or do you charge a separate fee?  Thanks in advance to any feedback!!!

PMRNC

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Re: Enrollment Question
« Reply #1 on: May 11, 2013, 11:46:37 AM »
Can you be more specific when you say "enrollment"?  are you talking about enrolling with the carriers for electronic claims or are you talking about "credentialing" with carriers.. ? There's a difference. I don't charge anything for the standard enrollment process as it's a must to setup services. For credentialing yes I have various credentialing packages I offer my clients as a separate service depending on the level of credentialing they want done. I also have separate contract and fees in that contract with it.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Matty

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Re: Enrollment Question
« Reply #2 on: May 11, 2013, 08:54:31 PM »
Yes sorry I was referring to enrolling In Network with the various Insurance carriers.  We also including setting up NPI and CAQH accounts if the Provider needs it created. 

PMRNC

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Re: Enrollment Question
« Reply #3 on: May 12, 2013, 08:27:14 AM »
I do all my credentialing on a separate contract.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Matty

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Re: Enrollment Question
« Reply #4 on: May 17, 2013, 11:36:40 PM »
  FYI at the HBMA conference they sternly stressed the fact that obtaining network contracts for our clients is not "credentialing" and to be careful calling it that.  If you are physically verifying their credentials and performing background checks, then great call it credentialing.  But if you are only collecting the documentation from your providers and completing the insurance applications, you are doing enrollment.   Most of the people in the room had the "oh crap" face so I wanted to point that out.  You may do all of it, I have no idea, but I am sure there is quite a few members of this site that will have the same look we did if they read  this thread.  :D

It scared us a little so we went back through and changed the verbiage on our website and advertising materials.   Thanks for the feedback though, it seems like most billing companies do not include the service so we may need to rethink that approach too.



Can you be more specific when you say "enrollment"?  are you talking about enrolling with the carriers for electronic claims or are you talking about "credentialing" with carriers.. ? There's a difference. I don't charge anything for the standard enrollment process as it's a must to setup services. For credentialing yes I have various credentialing packages I offer my clients as a separate service depending on the level of credentialing they want done. I also have separate contract and fees in that contract with it.






PMRNC

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Re: Enrollment Question
« Reply #5 on: May 18, 2013, 08:17:07 PM »
Quote
  FYI at the HBMA conference they sternly stressed the fact that obtaining network contracts for our clients is not "credentialing" and to be careful calling it that.  If you are physically verifying their credentials and performing background checks, then great call it credentialing.  But if you are only collecting the documentation from your providers and completing the insurance applications, you are doing enrollment.   Most of the people in the room had the "oh crap" face so I wanted to point that out.  You may do all of it, I have no idea, but I am sure there is quite a few members of this site that will have the same look we did if they read  this thread.  :D

Respectively I disagree.. their own forms and packets say "credentialing". I see nothing wrong with it. There are many levels to credentialing, that go way beyond enrollment.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com