Category Archives: Credentialing

The Most Common Medical Credentialing Mistakes

We’ve discussed how important getting your physicians credentialed can be. Not only does it allow physicians to be “in-network,” but it can also make sure that a physician is qualified to treat patients. However, the medical credentialing process can be complicated, and there are many mistakes that health care providers can make throughout it.

Relying on a limited staff

The Most Common Medical Credentialing Mistakes

Medical credentialing can be a long, drawn-out process that requires patience and extreme attention to detail. Your staff, no matter how talented they are, may be out of their depths when it comes to medical credentialing, especially since they have other obligations to attend to.

Accepting incomplete forms

In order to be credentialed, your physicians will need to fill out an application. These applications require a lot of information, so it can be tempting for some to ignore certain parts. However, when it comes to credentialing, no stone can be left unturned. Incomplete applications should never be accepted and they must be filled out in their entirety.

Not updating or verifying information

Medical credentialing isn’t a one and done situation. A physician must be credentialed regularly according to the laws of the state in which they practice. As such, you will need to update a physician’s information so that you are aware of all of their board certifications and licenses. Without doing so, a physician could start performing procedures they’re not technically allowed to perform.

Here at Medical Revenue Associates, we can take on the credentialing process so that you don’t have to. Give us a call at 215-497-1001 to learn more.

The Dos and Don’ts of Medical Credentialing

Medical credentialing is a necessary, but complicated, process. After all, ensuring the qualifications of a physician is easier said than done. While medical credentialing will never be easy, there are ways to make it less stressful on you and your physicians. Here are some things you should do, and some things you shouldn’t do, when…

Individual vs. Group Credentialing

Medical credentialing ensures that a physician both has the proper education to perform their services and is “in-network” with health insurance companies. As such, the credentialing process involves collecting and evaluating all available data on a physician in order to ensure their credentials. While you can credential individuals, you can also credential people as a…

Common Questions About Medical Credentialing

Medical credentialing and contracting is required for a provider to receive payment for their services. Medical credentialing is a complicated process that takes time and precision. There are many steps and doing just one thing incorrectly can upend the process. Here are some of the most commonly asked questions about medical credentialing: How long does…

What is Medical Credentialing?

Ensuring a healthcare provider has the proper education, training, certification and credentials not only makes certain that they are qualified to provide care, but it is also integral to being “in-network” with health insurance companies. Credentialing makes this happen. But what is it and how, exactly, does it work? Here are the details: Credentialing—The Basics…

Credentialing Services: Adding or Removing a Physician from Your Carrier Profiles

Being a practice within a managed care carrier network or multiple carrier networks means inevitably having to add or remove a physician from your carrier profile. This process involves an application process (completing the 30-page Council for Affordable Quality Healthcare (CAQH) questionnaire) for a specific network and must be completed whenever there is a provider…

Credentialing Services: Benefits of Joining a Carrier Network

Taking the time to join an established provider network can sound like a huge drain on office resources but doing so can be a major benefit for healthcare providers in the practice, as well as your patients. In-network vs. out-of-network Most patients with insurance have the option of choosing a doctor or healthcare provider that…

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. However, becoming a credentialed practice is not necessarily a brief and easy thing to do. The process usually takes…