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Choosing Better Medical Care
3 Things You Need To Understand About The Medical Credentialing Process
Chris Burke
If you want to practice and work with patients, you need more than your medical license. You need to go through the medical credentialing process so that you can get on insurance panels and treat patients who have that specific insurance.
#1 The Medical Credentialing Process Is an Insurance Process
The medical credentialing process is a process that insurance companies have medical providers go through. One has to go through the medical credentialing process for each insurance company whose insurance one wants to accept. You cannot simply choose to accept a patient's insurance; you have to go through a credential process with that insurance provider so you can treat all patients who have that particular type of insurance.
#2 The Credentialing Process Takes Time
Second, it is important to understand that the credentialing process takes time. It is not something that can be completed within a couple of weeks. It is a process that generally, if everything goes correctly, takes a couple of months.
You have to complete and submit a detailed application to the insurance companies that you want to work with. Then, you have to follow through with the insurance companies to see if they need any additional information and to move the process forward.
It can take the insurance company some time to verify all of the information in your application, process your application, and add you to their system.
#3 You Want to Be Credentialed With Multiple Insurance Companies
The insurance companies that you want to get credentials with are referred to as panels. For example, you may be approved for general care for a certain insurance company but not for more specialized care. There are different panels within each insurance company that you have to apply for.
Ideally, you want to become credentialed with multiple insurance companies. A medical credential company can help you identify the more popular insurance companies in your area and help you obtain credentials with them. If you want to be able to serve a large population, a medical credential company can also identify smaller insurance companies in your area and get you approved to provide treatment for those customers as well.
If you want to open up your own practice, or open up a practice in a new area, you are going to need to go through the medical credential process for all of the insurance companies and panels who you want to provide service for their patients. Keep in mind that this is not a quick process, and you should plan on having to wait a few months for your credentials to process.
To learn more, reach out to a company like Med USA.
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