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Credentialing New Clinicians to Your Grouping Practice

BY MAUREEN WERRBACH

Are you looking to accept clinicians accept insurance in your group practice? If and then, you may be wondering how to start the process; what to practice first, who to contact, what insurances to panel with, or how to actually panel with insurances (as a group or individually). Insurance credentialing is ofttimes the bane of many clinicians' being, from misplacement of documents from insurance companies to long wait times before getting paneled, to dealing with participation denial. Let's take a look at some of the main questions group practice owners have about paneling new clinicians.

1. How do I effigy out which insurance companies to console with? Start with asking local providers what insurances they are taking, the pros and cons of that insurance company (i.e. their rates, ease of sending claims, promptness of payment, etc.). Make up one's mind what is important to y'all regarding an insurance company and make sure to enquire a potential insurance company nearly it. Your best bet is checking with local providers, or going to Psychology Today and searching providers in your area and seeing which insurances they accept.
2. Should new clinicians panel individually or under my group? And for that matter, should I set up a grouping contract with the insurance visitor? So, this depends on a few things. Some insurance companies allow group contracts, and some merely allow private contracts. This may be the deciding gene. For instance, in Illinois, United Healthcare allows you to take a grouping contract one time y'all have 5 clinicians, Magellan allows group contracts with just i clinician, and Cigna doesn't allow group contracts. What's of import is that your clinicians credential usingyour grouping practice NPI-2 and Tax ID,non their social security number or under their name only. Doing so volition effect in them receiving checks in their proper noun and y'all having to chase information technology down from them. You want checks to go to your business, so that yous can manage that and pay your clinicians from that. The best fashion to ensure that is that they fill out a w9 with your practice name, Tin can and address, so that insurances know to send checks to your business. A do good to applying every bit a group (if it is possibly) is that y'all can negotiate rate increases more easily than a solo provider. Also, the process for calculation clinicians is easier and less fourth dimension consuming if you are a grouping (you just "add" them to the group) versus everyone individually applying. The potential drawback is that if a clinician wants to leave your practice, they will essentially have to restart the whole paneling process if they are paneled under your group versus if they are individually paneled, they can often just add together a new location and delete your practice from their contract (although I have seen a few companies who still brand clinicians panel all over again for new practices).
3. What do I do in one case my clinicians take completed their application to participate? The about of import thing is that they verify with the provider relations department that they received the documents. Y'all would be surprised (or non!) by how often things get lost in transit and never achieve the right section or person. I take clinicians check within a week by calling or electronic mail the provider relations department to verify they have received their credentialing paperwork. After that, I tell clinicians to cheque each month to brand sure that they aren't missing whatsoever documents or need anything more from you. Frequently, something simple similar "Are yous ADA accessible," or "What are your function hours," are the things that stall an application.

My one proposition would be to put together a credentialing packet, with your business data that clinicians would need to utilize, like your practice and remit address, Tin, NPI-2, telephone and fax number, a completed w9, how to utilise for a CAQH number (with a link to the website), how to use for an NPI (with a link to the website), and a list of the insurances you would like them to panel on, forth with whatever provider relations contact phone number or email, and a link to the awarding on their website since most have an online awarding. This makes the process easy for incoming therapists and reduces the corporeality of times they contact you for information!

Although credentialing tin can be a hassle and takeslots of time, many practices are rewarded with many new clients by using insurance. If you demand assist with the credentialing/paneling process, a neat resource is Danielle Lapidus at Be Your Ain Biller. Practiced luck!

Maureen Werrbach is a psychotherapist, group practice possessor and group practice jitney. Learn more than about her coaching services here: Learn More than Hither

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Source: https://thegrouppracticeexchange.com/articles/credentialing/

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