What to Know About Credentialing and How Long Does the Process Take?

Being a credentialed practice helps you get “in-network” with insurance companies. Patients will almost always look for providers that readily accept their insurance, as it usually more cost-effective for them and makes the payment process easier.

Insurance Credentialing Bensalem PA

However, becoming a credentialed practice is not necessarily a brief and easy thing to do.

The process usually takes at least three to four months. Here is an outline of the major steps in the process:

Look into your prospective insurance companies

Figure out which insurance companies you want to be credentialed by and determine what steps need to be done for each company—the process can vary.

Complete the Council for Affordable Quality Healthcare (CAQH) questionnaire

This is required by most major insurance companies in order to be credentialed. It involves starting an application with the CAQH, getting invited, filling out the 30+ page application the data from your resume, and confirming all this information is correct four times a year. Any hiccup or error in this process can result in a delay.

Spend hours filling out paper forms

This includes filling out applications, gathering documentation, and following up with insurance companies to ensure they’ve received all the required information and that there are no errors or other issues. It’s recommended to call every two weeks to make sure the process is still moving, and that you haven’t been rejected.

If all of the above sounds overwhelming, or like you may not have the resources to properly devote your practice to the credentialing process, consider using a reliable credentialing service.

At Medical Revenue Associates, Inc., we understand the requirements of individual insurance companies and can effectively streamline this process. Not to mention, hiring a credentialing service will most likely save you money in the long-run. If you’re interested in learning more about becoming a credentialed provider or medical practice, give us a call at 215-497-1001 today!

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