Category Archives: Credentialing

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 group, and the type of credentialing process you choose will depend on what benefits you or your practice the most.

Individual CredentialingIndividual vs. Group Credentialing

Individual credentialing is as it sounds—you’re being credentialed as an individual, rather than as a group. This means that you’re given your own tax ID number, and you’re able to keep those credentials as you move between practices. However, since individual credentialing is specific to the person, that means you will only be credentialed in the specialties that you’re licensed in, and health insurance companies can be more particular about what will and won’t be covered.

Group Credentialing

Unlike individual credentialing, group credentialing is when physicians are credentialed as a group. You’re not given your own tax ID number (rather, you are all assigned the same tax ID number) and each physician must meet the specific requirements laid out by the credentialing panel before the entire group is accepted. Group credentialing is often more beneficial to practices because the credentialing doesn’t follow a person when they leave that specific practice. This means that you won’t be paying to credential someone only to have them leave.

If you’re looking to credential yourself or the physicians at your practice, then contact Medical Revenue Associates to get started.

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…