General Category > General Questions

Pricing on Credentialing

(1/2) > >>

macbook:
Hello Alice,

In your book, Completing the 855i, it was mentioned that a $125 fee is charged. We are deciding how to price our credentialing. I also got your book on Pricing but did not touch on how to price credentialing. Hope you can share some insights on how to price this as well.

Thank you,

PMRNC:
To me that's way to high for just Mediacare since it's standard, quick and easy. With all the others it depends on what level of credentialing you are doing. there is Level one which is just LOI, applications and status check and then level 2 which goes into fee schedule negotiations and contract review (should not be done w/out an attorney to sign off on contracts).  The fee can greatly be increased with doing full leveled credentialing. I've charged between $100-$200 per hour.

Michele:
The $125 is just for credentialing with Medicare, no fee negotiation.  However, it includes tracking the application thru the finish, submitting any requests for corrections or additional information.  It also includes the 460 & 588 EFT and 855R is needed.  I would agree the $125 is high if it were just for completing the 855I but it is more involved.  I find that the work I do after we've submitted the I is where my time is taken up.  Chasing the provider down to get corrections, new signatures, etc.  Also, we did a comparison of others across the country and we actually are under priced by a lot, believe it or not! 

macbook:
Hello Michelle and Linda,

Thank you so much for your reply. We are having an increase in credentialing for new providers and providers new to the practice. I am just having a hard time with pricing whether to charge for each insurance or as a package and how much.

But the list can really go up to 30 insurances/payers/networks all together or more.  And sometimes the corrections, and the issues I have to deal with, with established providers wishing to start their own practice having all their information in a chaotic state and fixing their information and getting it right in all the applications and getting their docs in order, especially getting them privileges in hospitals and of course Medicare. I sometimes feel if it is worth the price. Your book helped a lot. I am using a different email here in the forum. But the Medicare book really helped a lot especially when I was starting. How I wish Alice could help in the pricing as well as negotiating contracts. Negotiating contracts will really help our clients get better returns.

But, anyway, thank you again for all your input. 

billinggirl:
How would you track your hours if you charge the 100 to 200 per hour rate?

Navigation

[0] Message Index

[#] Next page