Account Matters offers easy credentialing services to help you get enrolled with the insurance companies of your choice. Our experts submit your applications and handle all of the follow-up with insurance companies, saving you time and frustration.
What is the Credentialing Process?
If you've never dabbled with credentialing, you may be unsure where to even begin. Begin by identifying your patient demographics to determine which insurances would be most beneficial to be in-network. Once you have your list of potential provider networks, you can initiate the credentialing process.
The credentialing process for most health insurance companies is simple.
While the process may seem straight forward, there are many issues that can crop up during the credentialing process that can delay your enrollment.
Each insurance company has their own credentialing process with their own unique timeline. For most commercial insurance companies the credentialing and contracting process can take 45-120 days.
While there isn't a way to speed up the credentialing process, there are a few things providers can do to ensure their applications process as quickly as possible.
The required documents for credentialing vary depending on what you are trying to accomplish. If you are getting a new group credentialed and contracted, you will need a whole lot more information than if you are simply adding a provider to your existing group.
Here are the business documents you will need before you can even think about starting with credentialing.
You or you therapists will need a bunch of informational/documents.
Having these documents in hand when you begin the credentialing process will save you time and stress instead of scrambling to try and get all your ducks in a row before you can submit your application. For all required documents, it is of the utmost importance that the information on these forms match what you are putting on the credentialing application.
Health insurance companies need the most accurate and up-to-date information for the provider groups and individual providers in their network. Not updating your information on file with the insurance companies can lead to denied claims or payments being sent to the wrong address.
Here are some examples of events your business could experience that would require some level of credentialing/enrollment.
Recredentialing is the re-verification of the information that insurance companies have on file for a provider group or individual providers. In order to remain in-network with the insurance, providers are required to submit updated copies of important documents such as license or liability insurance.
The recredentialing process is quicker than the initial credentialing process but it is still vital that practice staff are clear on when their recredentialing is due and what documents need to be submitted for each insurance. Failure to recredential may result in the termination of a provider from a group or the termination of a group's contract entirely.
Most insurance companies let providers know when their recredentialing is due months before the deadline but we recommend your staff uses Recredentialing Tracker tool so your staff can be prepared.
Credentialing is a process that requires a keen eye for detail and lots of patience. Front office specialists try to obtain the status of applications and contracts. If your staff is unfamiliar with the enrollment process for your area, the task becomes even more difficult. Outsourcing your credentialing to experts can save your staff time and frustration.
As experts in credentialing, we know the processes to enroll groups and providers with insurance panels quickly and efficiently. Outsourcing the credentialing process means no more wait on hold with insurance companies for a stress free enrollment.
For more information about how Account Matters helps you practice get in-network with the insurances you want, simply fill out the form at the top of this page.