Wiki Cpc

[ldodson09]

Good morning,

My provider is looking into hiring new providers to join his practice and I am needing assistance in credentialing a doctor and NP/PA is there in hints and/or website that can help me complete this task. The provider is wanting to have this done by end of January and I think I will need the new providers credentialing in our state (North Carolina) along with the insurances that our office accepts. Any help is greatly appreciated.

Thanks again,

Lisa Dodson CPC

 

[ntreber]

If the providers are newly licensed and you take Medicare they will need a Medicare enrollment. If you take your states Medicaid then you will need have a Medicaid enrollment / credentialing as well.
You will also need to credential them with any other insurance you are contracted with and them either have them added to your contract or get an additional contract for each provider with each private insurance. The contracting part will depend on the private insurance and how you are currently contracted ( ie: Group or individual).
Most private insurance take anywhere from 30 - 90 days just for credentialing.
You should have a state approved "Provider Credentialing Application" and you should be able to find it on the state website. There are also some private insurers that require credentialing be done through a site like CAQH. The fasts way to determine what each insurance requires is to go to their web site and review their contracting policies Generally found under a topic of join the network or provider contracting.