Fast and Accurate Credentialing: FAQ for Account Management

credentialing-for-entWhile it is easy to find information online about all types of account management for otolaryngology billing and coding, ICD-10 changes and much more, one of the areas that you won’t find a lot of details is in the realm of credentialing. MD Pro Solutions provides credentialing services for every single provider in your office. We have been working with ENT physicians, practices and clinics for over 45 years and that has helped us to be able to provide a comprehensive selection of fast and accurate credentialing services to our clients.

In addition to basic services, we can also include all of the essential documents with each completed application, include the current licensing, CMEs, declaration pages, malpractice narratives, certifications and much more, all before sending it to your office to receive signatures. Our credentialing services are only for insurance payers – not for hospital privileges and other services – in order to better serve our target market of otolaryngology specializing physicians and clinics. To get an even more clear picture of the services that we provide, continue reading at the end of the article after we address the top questions that most practices have about credentialing for otolaryngology billing and coding.

Frequently Asked Questions: What Do You Need to Know About Credentialing?
Medical credentialing can be a difficult task – even for the most knowledgeable medical professionals. Understanding what it is, how it works and how a service like MD Pro Solutions can help to clear up the process and get you the fast and accurate credentialing you need, will help you to improve account management and allow you the time you need to prepare for other impending issues in the medical billing world, such as the upcoming ICD-10 changes and more.

Question #1 – What Is Insurance Credentialing?
This is the process used to help providers become affiliated with insurance companies so that they are able to receive third-party reimbursements for medical billing claims. While some practices used to consider this process as an “optional” service, the many changes in the realm of medical account management have made it more important than ever before. As more and more citizens in the United States get on health insurance, there will be less patients paying out-of-pocket for services, and more patients using health insurance to cover their medical services.

Question #2 – When Can I Apply for Credentialing?
While most of the insurance panels do allow applications to be filed immediately after receiving a medical license, there are a few that require between one and three years of experience running your practice or clinic before they will even accept your application. Each state has its own set of regulations, so when you work with a professional company, such as MD Pro Solutions, to provide you with fast and accurate credentialing for your otolaryngology billing and coding, it is important to make sure that they are well versed in the requirements for your state.

Question #3 – Will the Affordable Health Care Act (AHCA) Affect Credentialing?
While it won’t affect the credentialing application process in any way, hindering you from proper account management or reimbursements, a lot of transitions are happening with regard to insurance companies and insurance panels. In addition to all of the coding transitions that medical practices are enduring for the ICD-10 changes, it is important to stay on top of credentialing as well. As more and more people become insured, you will need to work with more providers in order to be able to offer a wider selection of options. Experts anticipate that more insurance companies will be formed and existing companies will offer more options as the fallout from the AHCA becomes more widespread.

Question #4 – How Long Does the Process Take?
This should actually be the first question on our list, as it is the question that most of our clients ask about before anything else. The truth is, it can take a couple of months to become fully credentialed and ready to accept patients through a particular provider. MD Pro Solutions offers fast and accurate credentialing without all of the red tape, providing our clients with the fastest possible results. However, it is important to understand that it takes approximately 30-days or more for each part of the process to make its way through the insurance company, so it definitely won’t be overnight.

Question #5 – What Documents Do the Insurance Companies Require?
When your credentialing application is being processed, there are several documents that will be required by the insurance companies. First, they will require a resume in the month and year format, providing explanations for any gaps in your work history. Copies of your current license – with expiration date, current liability insurance and a diploma that shows the highest degree that you have earned, will also be required.

Question #6 – Isn’t There an Easier Way?
Yes! Companies who are looking for fast and accurate credentialing without all of the time, effort and work that it requires can hire professional services like MD Pro to provide them with full service medical credentialing for otolaryngology billing and coding. Ensuring that you have a proper spectrum of account management tools and abilities at your disposal is the best way to run a successful ENT practice.

Call MD Pro Solutions for Fast and Accurate Credentialing
Our highly trained, knowledgeable and experienced team of professional service providers can help you with a wide variety of services, including preparation for ICD-10 changes, outsourcing account management, as well as top quality, fast and accurate credentialing. As promised, below is a list of some of the credentialing services that we provide to our clients. If you have any questions about our services, make sure to contact us by phone or on our website through our handy online form.

Some of the key credentialing services that we provide include:

  • initial credentialing and re-credentialing for every single provider in your office
  • complete record keeping services for all applications made to insurance providers
  • completion and storage of all 855 forms for your Medicare patients
  • preparation of all applications, including any relevant documents
  • professional, yet personal service, including on-site visits to your location as-needed
  • credentialing for new providers, helping to save time and money

To learn more about any of our professional services, including otolaryngology billing and coding, ICD-10 changes training and preparation, as well as fast and accurate credentialing, give us a call at 508-946-1665. Find out how MD Pro Solutions can help your ENT practice increase revenue, provide more account management options and offer a wider range of services to your patients.