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
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
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
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.
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,
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
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
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,