Credentialing

Credentialing

Avoid Missed Medicare Revalidation Deadlines

Please Note: Effective October 1st, 2021, CMS will restart Medicare revalidations for providers and supplies. Prior to this, revalidations were put on hold due to the COVID health emergency.  To determine if you have an pending or upcoming provider revalidation you can utilize Medicare’s Revalidation List online. medicare revalidation lookup. Although Medicare has put a temporary […]
medicare revalidation lookup

Medicare Revalidation: How to Easily Find Your Due Date

Please Note: Effective October 1st, 2021, CMS will restart Medicare revalidations for providers and supplies. Prior to this, revalidations were put on hold due to the COVID health emergency.  To determine if you have an pending or upcoming provider revalidation you can utilize Medicare’s Revalidation List online. medicare revalidation lookup. As a leader in your practice, […]
PECOS login

Accurately Choose Your PECOS Login Surrogacy Designation

CMS rules do not allow you to use your provider’s login credentials to manage their Medicare enrollment and ongoing revalidations in PECOS (Provider Enrollment, Chain, and Ownership System). There is a more efficient, compliant process you should be using to manage this. PECOS login. To be compliant, you must set up a PECOS login surrogacy […]
pecos-medicare-enrollment

Use PECOS to Speed Up Medicare Enrollment Efficiency

Whether you’re enrolling your provider with Medicare for the first time or responding to a revalidation request, knowing how to correctly utilize CMS’ Provider Enrollment, Chain, and Ownership System or PECOS Medicare enrollment system is essential. What is the PECOS Medicare Enrollment system, anyway? PECOS is an internet-based enrollment process that provides you with an […]
credentialing and enrollment

Master the Differences Between Credentialing & Enrollment

Interchanging the terms credentialing and enrollment is a surefire way for your provider reimbursement to take a serious hit. The problem is that there is definitely overlap between them. Ultimately, however, having a solid understanding of each process is the only way to more efficiently and accurately manage your payor approval process and to get your […]
CAQH ProView Portal

CAQH ProView Portal: Make Credentialing/Enrollment Faster & Easier

Your patients pay for their health insurance and want to use it. This means that if you want to treat them, you need to be enrolled in their health insurance plan. Participating in insurance networks almost certainly guarantees you will be required to utilize the Council for Affordable Quality Healthcare (CAQH) ProView Portal, and it […]
CAQH Profile

Comply with 2021 CAQH ProView Changes & Avoid Payment Delays

Keeping your provider credentialing up to date is critical to your practice’s financial success, and your CAQH profile is a big piece to that puzzle. 2021 is bringing significant updates to CAQH ProView that you can’t afford to miss. It’s imperative that you get a handle on these changes now otherwise you’ll feel it in […]
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 […]
Physician Credentialing

Physician Credentialing: Prevent Cash Flow Break with NPI Accuracy Essentials

Make no mistake! Setting up and maintaining the accuracy of each of your physician’s National Provider Identifier (NPI) is essential and COMPLEX. Any error will result in your reimbursement being delayed and a hit to your practice’s cash flow. As a Medicaid/​Medicare provider, you are required to obtain a NPI to get paid from CMS […]
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 […]
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