Medical Billing Tips - Provider Credentialing

August 27, 2014 by Antonio Arias, MBA, CHBME

Topics: Medical Billing, Revenue Cycle Management

All medical billing is predicated on physicians being credentialed, but the process has become increasingly difficult due to payer and state-specific requirements. Here are three tips to make your provider credentialing easier:

Don’t procrastinate -- Whether you are a solo provider managing your new practice or you are a multi-provider practice adding a provider to an existing facility, you need to start the credentialing process early. Target 150 days before the provider plans to start seeing patients to begin credentialing.

Confirm your state’s regulations – The process of obtaining a medical license, either initial licensure or a second or subsequent license in another state, can be a challenging process. To help physicians navigate the licensure process and to provide up to date information on licensure requirements across all US states and jurisdictions the AMA publishes annually State Medical Licensure Requirements and Statistics

Use the CAQH program – Utilize the credentialing program offered by The Coalition for Affordable Quality Healthcare (CAQH). Most payers have adopted these standards, making the process easier for physicians.

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