Monthly Archives: October 2015

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Credentialing – The Key To The Castle

Credentialing is the lynchpin to reimbursement from any insurance provider. Before you submit any claims for your new practice, or if you want to continue submitting insurance claims – you must have your providers credentialed.

If you fail to keep your providers up to date with their credentials and the management of that information will inevitably lead to a loss of revenue and endless headaches. As an independent practice, managing the details of credentialing can be tedious and time consuming. Whether you’re filling out application after application, gathering documentation or waiting on hold with payers and their representatives, your time is too valuable to spend doing all of this.

While many medical billing companies will say they can handle your credentialing needs, Medical Claims Billing has a team dedicated to the credentialing of our providers. Our extensive experience with credentialing requirements, combined with the attention to detail and management of your account ensure that no claims get missed or denied due to a non-credentialed provider. Here’s how we can help:

If You’re A New Provider

You might be ready and eager to see your first patient, but hold your horses. If you plan to accept insurance, you must credential with most insurance companies to receive reimbursement. We will help you credentialing and contract with the insurance companies of your choice.

If You’re Starting a New Practice

Perhaps you were previously credentialed under a different medical group or you’re in a new state and have to meet different requirements. Changing your tax ID could require that you obtain credentials from all of your insurance providers.

Are You Adding New Providers

Great news! Your practice is doing well and you need to add providers. Some insurance companies will require group contracts for practices with more than one provider. Each provider will need to be credentialed and either added to the group contract, or have an individual contact that will pay to the practice tax ID. Medical Claims Billing is there to help make that happen.

New Insurance Payer

If you’re looking to accept new insurance plans, we can not only help you with the enrollment, but we can also review reimbursement from similar specialties and see which plans might make the best fit for your business.

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To Superbill or Not To Superbill…That is the question

Focusing on the patient encounter is one of the most critical aspects of your practice. Not only does an encounter that allows for focus and attention on your patient produce the best experience and feeling for the patient, but it also allows for the best possible communication and most accurate diagnosis.

Whether you find that a paper superbill which can easily and securely be shared with your billing service or a robust EHR/EMR integration is the best bet for your practice – the key is to make sure that this process allows for the time and attention to be spent where it counts – with your patient.

While the benefits of an EHR/EMR system are significant, it may be worth considering a system that allows providers to capture the essential details in a paper format and then allow office staff to transcribe this into an EHR/EMR. Patients regularly voice their displeasure with providers who are too focused on their tablet or computer and don’t look their patient’s in the eye.

Medical Claims Billing is hands on with our practices and we work closely with them to develop an operational strategy to maintain high levels of patient satisfaction while also bringing the best integration of technology to ensure quick, accurate health record and claim creation.

Whether your preference is paper, digital or a combination of both, Medical Claims Billing can help.