Credentialing Services

Do You Take Insurance?  If So, Which Ones?

Is this a question you get from patients/clients often?  Does your answer invite them to work with you or turn them away to someone else?  One of the most important aspects of running a successful business is ensuring a continuous positive cash flow.  While there are various payment methods you may choose to offer your patients/clients (i.e. cash, check or charge), insurance should definitely be a consideration at the top of the list.

By going thru the credentialing process with various insurance carriers, which is required to become contracted with a carrier as an in-network provider, you agree to accept a preset reimbursement rate for services rendered to your patients/clients directly from that insurance carrier *.  We will help get you credentialed with any of the major insurance carriers/plans, including Medicare and Medicaid, as well as begin your ability to start insurance claims processing today.  Most provider types nationwide can be considered for credentialing with various insurance carriers across the nation including acupuncturist and even massage therapists.  So why wait, contact us today to learn more about it!

Question: What is Medical Credentialing?

Answer:  Medical Credentialing is the process of submitting your application and various other required documents to an insurance carrier for consideration to participate/contract with them as a new in-network provider.  Credentialing with insurance carriers varies from 90 days to 120 days, depending on the insurance carrier (in rare cases, even longer depending on their volume of applications).  Once credentialing is completed and the insurance carrier has uploaded a signed contract into their system with all of the provider's information for claims payment, you are considered in-network with an effective date to begin seeing patients/clients as in-network.

Question: Why would I want to go through the process of becoming contracted with different insurance companies/carriers?

Answer:  Once you are participating as an in-network provider with different insurance carriers, you will be able to increase your patient/client base and your income/cash flow due to the fact that many patients/clients only go where their insurance is accepted!

Question: What is the current reimbursement rate for my provider type?

Answer: Reimbursement rates vary by provider type, provider licensing/education level and by region too.  However, with our extensive background of working with various provider types, we are generally able to provide you with a good estimate of what you may expect for reimbursement according to the CPT code (procedure code) billed depending on your specific provider type.

Question:  What process will I have to go through to become credentialed?

Answer:  In most cases, you will need to fill out a lengthy application, which may vary with each insurance carrier.  The application provides the insurance carrier with information such as; schooling, licensing, experience, liability insurance coverage, languages spoken, etc.  Many insurance carriers are working to streamline this process with the aide of the CAQH Database which houses all of those required details for the credentialing process with the insurance carriers as well as other documents that they will require you to submit along with your application to join the network.  Once your application to join the network has been approved, then the insurance carrier will do their magic internally to add you to the network as an in-network provider under your licensed specialty.

Question:  What if I don’t know how to fill out the forms, complete my CAQH file, understand what additional documents they require or don’t have the time to do it myself?

Answer:  We will take care of the process for you completely, including creating or updating your CAQH file for you!