Starting a Medical Billing Business > Starting Your Own Medical Billing Business

Insurance enrollment charges

<< < (3/3)

kwardbilling:
I too have started to think about learning the procedure for credentialling, as I believe the counselors I work with would put this to use, and I also see that it could bring me in other clients.  I guess my question is similar, is this a process I can learn on my own, with the help maybe of this new book you have published Michele, or without any training would I be opening a can of worms?  I wouldn't expect to get in to the contract or fee negotiations, just applying ....any thoughts?

Michele:
I am not aware of any training out there for credentialing services.  I learned as I went.  That is not a good method when starting billing, but for credentialing it is different.  If you are interested in Medicare credentialing then I do think our new book would be helpful.  There is a lot of information in there about Medicare credentialing along with detailed instructions on completing several of the forms.

Good luck
Michele

PMRNC:
I actually took contract law classes and obtained my paralegal.. while credentialing I worked with the providers attorney's who helped me further and were there to sign off on any contracts/negotiations. I find clients want the full service but with it comes a price tag. I still require that all my providers that have me do FULL credentialing, contract reviews and negotiations have a practice legal counsel to give a FINAL thumbs up on. Their work is done with the exception of final review and any revisions they might have to protect my provider. I have a separate contract for credentialing that contains legal disclaimers and states the practice is obligated to have a final sign off by their attorney. In my experience I have found so many doing credentialing don't find all those loop holes in provider contracts that can really put a practice in a strong hold. (long opt out waits for example)
Medicare is the easiest and like Michele said.. Straight forward, no surprises :)  But I can tell you lots of stories about the private plan contracts, those carriers will insert all kinds of crazy stipulations in their contracts hoping to slip them by.

Also I think if you are going to offer credentialing it's important to know certain things like what to do if a carrier says their panel is closed. I've seen many just accept it, tell the provider and do nothing. There are ways to get into closed networks.

Navigation

[0] Message Index

[*] Previous page