Author Topic: Credentialing Service  (Read 818 times)

Ango_mark03

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Credentialing Service
« on: October 21, 2013, 06:34:13 AM »
Is credentialing a huge challenge for new practices?

Merry

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Re: Credentialing Service
« Reply #1 on: October 21, 2013, 02:40:36 PM »
I assume you are talking about a medical practice and not a billing service right?
Very time consuming and lots of paperwork. There are people who do this as a service for a charge of course. Are you thinking of doing this as a service or are you a practice?

And even when you send in the paperwork, some of the carriers process them rather quickly and some take months.

Merry

shanbull

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Re: Credentialing Service
« Reply #2 on: October 21, 2013, 03:48:02 PM »
It can be a nightmare if you don't have someone who knows what they're doing. This is one of those things where it's worth it to hire an outside professional to do it if you don't already have a staff member who has experience with it.

PMRNC

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Re: Credentialing Service
« Reply #3 on: October 21, 2013, 04:12:03 PM »
There are two tiers to credentialing.. Many billing companies starting out can offer the first tier which is basically the letter of intent, sending in the providers information and obtaining contract/fee schedule.  The SECOND tier is NOT that simple and does REQUIRE experience.   That is the reviewing of fee schedule, negotiation and contract review of the network.

Most start up companies are not equipped to deal with the 2nd tier of credentialing.
Linda Walker
Practice Managers Resource & Networking Community
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