CAQH credentialing process

CAQH Updates: Ace New Features and Speed Credentialing Process

QUESTION: I credential our providers via the online CAQH portal and I am confused by some of the recent updates. Specifically, the taxonomy code set change and the new NUCC grouping. Does CAQH now follow the NUCC code set? What other changes are new?  CAQH credentialing process. Parsippany, NJ subscriber ANSWER: The CAQH updates bring […]
PECOS Surrogacy

PECOS: Simple Solution Expedites Enrollment Process

QUESTION: I have been using my providers’ PECOS (Provider Enrollment, Chain and Ownership System) passwords and logins to update their Medicare and Medicaid enrollments. When I submit their information, the required signature at the end indicates that I am the practitioner, when I’m clearly not. Should we consider handling updating enrollments a different way? Question […]
Provider Medicare Enrollment

5 Steps Prevent Medicare Provider Enrollment Payment Delays

Completing a Medicare provider enrollment application correctly the first time can make the difference between revenue flowing in – or not getting your provider’s services paid until months if at all later. You’ve got to be on top of the entire complicated, deadline-laden Medicare provider enrollment process to prevent delayed or lost reimbursements. Speed through […]
Credentialing Hospital Privileging

Speed Up Doctor’s Hospital Privileging

QUESTION: Our providers have privileges at two separate hospitals. Every couple of years, they make us jump through a variety of hoops to keep our providers’ hospital privileges active. This year, one of the hospitals is asking us to send provider references. Who should we ask? Anonymous, Alpharetta, GA ANSWER: Hospitals typically ask for three […]
Provider Enrollment 101

7 Provider Enrollment Strategies Keep Your Pay Flowing

A simple provider enrollment or credentialing error can stop your physician or nonphysician practitioner from being reimbursed for treating patients. When you implement these 7 strategies you will be on your way to filing complete, accurate applications that get approved quickly so you can keep your patients provided for and your reimbursements coming. #1: Keep […]