Can I Do It Myself? Challenges of Self-Credentialing (Updated)

What is the #1 Challenge of provider credentialing?

Time. If a provider is trying to run their private practice and be credentialed at the same time, it can overwhelm them to the extent that they are missing deadlines for the applications, or missing appointments filling out applications. What do you mean? How much time and effort can it really take to get credentialed?

Probably a whole lot more than you realize! You have to fill out a new application for each and every insurance company you hope to be credentialed with. And each application will likely take you around 10 hours to complete. Then you can finally submit your application… but your efforts don’t stop there. THEN you have to call and follow up with each company to make sure your application has been received and is being properly processed.

What are the benefits of our credentialing specialists doing the process for you?

That’s right, we are happy to complete this process for you. With years of experience, our specialists know how to work with the insurance companies to get you credentialed and take the hassle of credentialing away from you.

Insurance companies are not great about telling you if there is a problem with your application or if something gets lost. Because they have so many providers, the insurance will not be the one to follow up. It relies on the provider to be the one to follow up with the process and applications.

Sometimes the insurance companies need a little push. Sometime companies will say, “I don’t have this,” or “I am missing this part of the application,” but really they have not looked into it. They just need a little push to show that you have completed the application and the process.

Can I bill under another provider?

Can interns, with a terminal masters (M.S.) that have passed the State Board Exam and have paperwork pending see clients and bill under a supervising provider? This will depend on the insurance company. Most insurance companies will not allow you to do so.

Thirty years ago, it was more common to be able to bill under a provider, but today it is called insurance fraud. If you do the wrong thing, and do bill under a supervisor, you could end up in hot water.

If you’ve had enough of fighting with insurance companies, and filling out provider applications, just to have those applications lost or rejected, give us a call at 1-855-664-5154 (847-483). Or to learn more, we have posted a handful of helpful videos on our FAQ Credentialing Page.