FAQ's
For many healthcare practices, credentialing can be both confusing and overwhelming.
At Credentialing, we provide a full-service credentialing solution. Let us handle the complicated processes and the repeated follow up calls with insurance companies for you.
Listed below are answers to some of the most frequently asked questions about the credentialing process. Take some time and review the information below or simply call us at (571) 281-8988 with your questions, and we’ll be happy to help!
Why would someone want or need medical credentialing?
Being credentialed with insurance panels means that you are able to see patients who have specific insurance plans and bill those insurance companies directly for the services you render. This can greatly increase the number of patients who can access your services.
Do I get to choose the Insurance panels I want to be on?
Yes. When you sign up for credentialing with us, you get to choose exactly which panels you want, and don’t want, to be credentialed with. Typically most outpatient physician providers credential with 7-8 payors, where as hospital based physicians (in-patient) usually credential with 10-15 payors (pretty much any patient with any insurance that comes to hospital). Physicians working in tristate area (border of 3 states) like in our physician owner practice credential with 25 payors.
How can I track my Medical credentialing progress?
Yes. When you sign up for credentialing with us, you get to choose exactly which panels you want, and don’t want, to be credentialed with. Typically most outpatient physician providers credential with 7-8 payors, where as hospital based physicians (in-patient) usually credential with 10-15 payors (pretty much any patient with any insurance that comes to hospital). Physicians working in tristate area (border of 3 states) like in our physician owner practice credential with 25 payors.
Most behavioural health providers, Therapists (PT, OT, ST, ABA etc) typically select 6-7 panels.
What if I don’t know which panels in my area are best for me?
We can help! One of our credentialing specialists will talk with you by phone and can help you to select the panels in your area that will be the best fit for you and your practice.
What are some of the more popular insurance companies?
The popularity of insurance companies varies depending on location. However, some of the most popular and largest insurance companies are Aetna, Cigna, Magellan, Tricare, United Healthcare, Humana, Value Options/Beacon Health Options, Medicare, and many others.
How many hours of work does insurance credentialing take?
The amount of time that it takes to complete the credentialing process varies by license type. For a standard outpatient practice, the Credentialing Team will put in between 10 and 12 hours of work for each insurance panel. If an appeal has to be filed, that will add a minimum of 5 additional hours of work to that panel.
Facility-based services, Home Health Care Agencies, and DMEs will all take over 20 hours to complete the credentialing process.
Have you ever credentialed or worked with providers in my area?
You bet! We have credentialed literally thousands of providers across the United States, including providers as far off as Alaska and Hawaii. No matter where your practice is, we have the experience needed to get you credentialed.
Have you ever credentialed or worked with providers with my license type/specialty?
We have credentialed healthcare providers of more types than we can list: from chiropractors to behavioral health providers to surgeons. If you are eligible to be credentialed, we can get you credentialed!
If you are providing a service that is new and innovative, we also offer research with the insurance companies to see if your specialty is eligible for credentialing. This can save you hours of headaches reaching out to the individual insurance panels.