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Credential question

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illenet2:
I am currently doing credentialing for a Physical Therapy Practice that has done only workers comp. cases. They now want to sign up the Physical Therapy Clinic with private insurance companies. The problem is they only want the PT Clinic itself to be credentialed & not the Doctor. I have never done it that way, so I am unsure whether this is possible? All the applications I have received from Ins. Co. seem to want a provider/doctor's name. Can I just use the head Physical Therapist or must I use the doctor? In other words, can I just credential the clinic only & if so, how do I proceed? Thank you, illenet2

Sportsmom:
You would need to check with insurances, some may credential only with a doctor and others will credential each PT.  You are not credential under the group then you will need to credential each one and thats a lot more paper work for you.

When I credential I do it for LPC, LCSW and LMFT the insurnces will not always credential the LPC and LMFT because we do not have doctor to review there charts, but they tell me that up front if I ask other wise I do all the paper work and then they sen dme a letter so I always ask first now.

Michele:
Most insurance carriers require that a group has at least one (some times more than one) provider when they credential a group.  I'm not sure if they will allow you to credential just the group. I also am not sure why the provider wants you to do it that way but good luck.

Michele

PMRNC:
I concur, usually if you are credentialing a group, each one must be credentialed, they are not just going to assume blind faith for each provider.

illenet2:
Thanks guys, your information verified what I believed as well. I need to do some more Insurance calling. illenet2

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