The practice is open and the waiting room is filled with patients ready to see you. As a nurse, your attention is on clients from all walks of life who are experiencing dozens of situations. Each day, the challenges are different, and your responsibility is to provide the best-possible service to your patients, from performing physical exams, getting health histories and providing health education to administering medications, wound care and other personalized interventions. Between patient care and running a quality practice, your time is valuable, and scarce.
With long hours devoted to patients and a practice, the overwhelming task of medical credentialing hovers over you. This process includes filling out piles of paperwork, making phone calls and waiting on hold, meeting deadlines for applications and making sure the process is on track. The job is compounded even more with follow up on the application and, in the worst case scenario, starting the process over if paperwork is lost or time has lapsed and the deadline is missed. It takes a tremendous amount of time to dedicate to medical credentialing, and most likely you do not have any to spare.
Our superior team can remove the hassle and burden of medical credentialing, allowing you the time and energy to provide to your clients.
This top-notch team is the solution to self-credentialing. They take care of all the details of the process from beginning to end. With extensive experience working with insurance companies and expert knowledge about medical credentialing, our dedicated team can help you avoid the overwhelming paperwork and hours spent on the phone with insurance companies.
The Importance of Medical Credentialing
Accepting Insurance is Essential
Medical credentialing is crucial to nurses, whether they are just starting out or maintaining a practice. Many long-time healthcare providers who have had successful, cash-only practices in the past are currently in the position of obtaining medical credentialing. Getting on insurance panels or becoming “in network” with insurance plans is vital, since the country’s healthcare has become more universally available. (Being on insurance panels allows practitioners the eligibility of accepting third-party payments from new and potential patients, which is critical in growing a practice.)
Patients Demand Covered Services
Due to healthcare reform, many practitioners who accepted cash-only payments before are currently serving more people with insurance plans. Healthcare costs are rising. HMO plans are becoming more popular than PPO plans, resulting in out-of-network benefits becoming obsolete. With healthcare becoming more balanced, it is possible for services to be covered whether the condition is new or pre-existing.
Patients today are vocal about asking if their insurance is accepted–in fact, they demand it. Gone are the days when patients were willing to pay out-of-pocket for services by physicians, chiropractors, mental health providers and other healthcare professionals. With the rising costs of healthcare premiums, they want to ensure their healthcare is paid by the insurance company. To keep up with the current market, healthcare providers do not want to exclude new patients, so they need to accept insurance. This means being enrolled in insurance plans or getting credentialed.
The Drawbacks of Self-Credentialing
Inordinate amounts of time and paperwork are involved in self-credentialing. To shoulder this task on your own, keep in mind the numerous guidelines needed for each insurance panel.
- Find out which insurance panels you want to be on.
- Carve out plenty of time for phone calls to search for the most updated insurance applications, and fill them out.
- Complete the various applications, which can range from 30 to nearly 100 pages. Attention to detail is imperative, because the applications require information in specific formats.
- It is important to follow up with each insurance company to confirm the application was received. If applications are misplaced and are not being reviewed, they could possibly languish in a pile—sometimes for weeks. In the meantime, the amount of time that passes may mean the application has expired, causing it to be rejected. If that happens, the process begins again.
- Submit supplementary documentation to the insurance companies.
- Again, spend time on the phone with each insurance company to make certain the materials were received and are being processed.
- In many instances, allow for additional time for clarification or more information necessary for the applications.
- Follow up at least biweekly to ensure the applications have not been lost or forgotten and are being processed.
- If an application is rejected, a formal appeal must be submitted in response.
Why We’re the Right the Choice for Medical Credentialing
Turn the frustrations of medical credentialing over to us. When you leave medical credentialing to our team, you’ll receive service that is second-to-none. The following are the benefits of choosing us.
- The experts help you choose the insurance panels that are right for you.
- You complete only one, simple form— The Master Survey.
- The credentialing team works diligently to secure your insurance panels.
- It is easy to track an application’s progress whenever and wherever you want, 24/7. Credentialing accounts online are in real time. You may also contact the credentialing team to receive a prompt update on your medical credentialing progress.
- The many healthcare professionals who have entrusted their medical credentialing with us find it is a great service that provides excellent results.
Medical credentialing is very affordable if you choose to work with us.
With a reputation for excellence, MedicalCredentialing.com is the choice for nurses, doctors, therapists, chiropractors and many other healthcare practitioners. Becoming credentialed with insurance providers is one of the most important things you can do for the benefit of your practice and patients, but it is also one of the most dreaded tasks of all. Our team can relieve you of the stress and time it takes for medical credentialing.
By allowing our team to provide their expertise in medical credentialing, you can focus on clients and running your practice. Our credentialing is effective, affordable and efficient. For more information and to get started on credentialing today, call 855-664-5154 or visit https://medicalcredentialing.com/..