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 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.
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.
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