Credentialing

They didn't cover this in grad school!

Whether you are working with insurance for the first time or transitioning from a group to private practice, I will navigate the process with the plans of your choosing to submit applications, get the contracts issued, and your credentialing approved.  You will know every step of the way: what is happening, what the expected timeline is, and when the process is complete with an in-network approval date.

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We will discuss insurance plan options with pros and cons of working with each plan.  You decide which plans will fit best with your practice model and business goals.  Based on your specific needs I will create, update, or offer guidance on utilizing CAQH, the online database insurance companies access to verify a provider’s credentials.  Your CAQH profile includes your demographic details, work and education history, practice location data, and documents such as your professional liability insurance certificate, W9, and license.

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I will handle sending any plan-specific requirements not covered by CAQH, which are needed on the application for enrollment.  Based on your responses and your CAQH data, I will complete and submit the enrollment application on your behalf to the targeted insurance plans. To ensure there are no snags, I will follow up with the plans and provide regular status updates until your credentialing is approved and the contract is executed.