When a new provider signs on to work at your practice, that’s when the provider credentialing clock should start ticking. After hiring someone, you must quickly get them credentialed and in the Medicare system so you can start billing for their services on day one. Unfortunately, many practices hit snags during this process that can delay enrollment, causing lags in the reimbursement process.

Check out these expert tips to ensure you can get provider credentialing process approved swiftly every time.

Confirm the NPI Name Matches Legal Business Name or Full Legal Name

According to most Part B MACs, the number one mistake practices make when submitting provider credentialing applications is a mismatch between names on the application. The name on your NPI application must be identical to the practice’s legal business name (for organizations) or the full legal name (for individuals). Even one letter placed incorrectly or one “&” in place of the word “and” could cause a rejection.

Your best bet is to refer back to the documents you used to enroll your practice in the National Plan & Provider Enumeration System (NPPES). The legal business name in that file is what should also be on the provider credentialing application. Leaving it off or filing a mismatch will lead to slower enrollments.

Always Include Required Attachments

When completing the provider credentialing and enrollment process, you must attach certain documents, which CMS will indicate on the form. This usually includes:

• IRS CP-575: This is the letter from the IRS granting you an employer identification number (EIN), which shows your legal business name and proof of your employer tax ID number.
• CMS-588: This is the electronic funds transfer (EFT) authorization agreement, which allows digital financial transfers.
• A voided, pre-printed check: This confirms your bank account number and routing number so you can be paid digitally.
• Copies of professional and business licenses: Showing Medicare that you have licenses, certifications and registrations can help speed up enrollments. Typically, you’ll only need to send copies and not originals.

Follow up Frequently

If the provider credentialing process seems to be moving slowly, get the contact information for someone at the payer’s office and follow up with them frequently, whether it’s via phone or email. Many experts recommend checking in once a week after about six weeks have passed. That way, you’ll stay on top of the process and the payer won’t let your application fall through the cracks.