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Top Changes to Provider Enrollment You Should Know About

  The changes in provider enrollment for 2017-2018 have been revealed and it seems that mid-level practitioners, independent nurse, and occupational and physical therapists will be affected the most. The amendments were proposed in April of this year and are scheduled, if all goes well, to go into effect in August of this year. It’s important to get yourself, or ...
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A Sound Credentialing Program is Like a Well-Designed Building

By Dilsa S. Bailey, CPMSM Architects first get a view of the land. Before they envision a building, they envision what would fit into that landscape. The architect then considers what occupies the surrounding space. It is then they start pulling it all together with drawings and photos and notes. That is typically how a credentialing or provider enrollment program ...
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Its Time To Go Digital With Credentialing and Provider Enrollment 300x300 | Category   Payor Enrollment | STATMedCare Payor and Physician Enrollment and Credentialing

Put down the pen and paper: It’s Time to go digital with credentialing & provider enrollment!

As more and more practices are employing providers, credentialing and provider enrollment have become THE priority in revenue cycle management! Enrolling providers correctly and quickly is the most important step in getting providers in-network with insurance plans. The quicker provider enrollment is completed; the quicker practices can be reimbursed for their provider’s services. In fact, the enrollment process should be ...
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Have You Ever Renegotiated Your Payor Contract & Fee Schedules?

Have you ever wondered if renegotiating contracts is really worth the time and effort? Is an increase in payment even possible? Will payers consider changing your contracted rates? According to The American Medical Association, doctors are working harder and earning less.  So much of what physicians’ face in their budgetary shortfalls is directly related to the reimbursements they receive from major ...
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10 Key Considerations: Outsourcing Credentialing, Enrollment and Contracting

An increase in the number of closed networks and reimbursement changes are just two of the factors making the credentialing, payor enrollment, and contracting processes more complex and more time consuming. Small healthcare organizations could certainly manage these processes in-house if they have the money, expertise and staff. However, large healthcare organizations, especially those that are growing, expanding or experiencing ...
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The Importance of CAQH

An important aspect of provider enrollment and credentialing is CAQH set up and maintenance. With rising healthcare costs, enrolling in CAQH can help relieve some of the healthcare administrative costs. A benefit of enrolling in the CAQH database/registry is having your credentials and demographic information in a centralized location. However, the initial set up of the registry is very complex ...
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Benefits of Outsourcing Credentialing and Payor Provider Enrollment

Just a few years ago, healthcare professionals considered payor enrollment to be optional for building their practice. Today, it has become more necessary than ever for providers to be in-network with insurance companies. This is partly because more people in the U.S. have health insurance than ever before, but even more-so because patients desire (even demand) to use their health ...
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Top 5 Provider Mistakes.5.3.2016 300x300 | Category   Payor Enrollment | STATMedCare Payor and Physician Enrollment and Credentialing

Top 5 Provider Enrollment Mistakes

Provider enrollment, or payor enrollment, refers to the process of applying to health insurance networks for inclusion into their provider panels. For commercial insurance panels, this process involves two steps; (1) credentialing and (2) contracting. For government plans, i.e., Medicare, Medicaid, TriCare, etc., this process includes a very complex and involved series of applications. The first step in the enrollment ...
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