Wiki Medical Office Credentialing

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zohrehf

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Hi,

I am doing billing for a Medical Group. A new doctor asked me to do all of his credentialing with insurance companies for his new practice. Could you please help me how much I have to charge them for this service. Since this is the first time I want to do for one solo practice, I am not sure how should charge them. Thank you
 
zohrehf said:
Hi,

I am doing billing for a Medical Group. A new doctor asked me to do all of his credentialing with insurance companies for his new practice. Could you please help me how much I have to charge them for this service. Since this is the first time I want to do for one solo practice, I am not sure how should charge them. Thank you
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I would agree on an hourly rate and then document all the time you spend on the project. Credentialing time varies significantly depending on who you are dealing with.
 
zohrehf said:
Thank you. Could you please give me the average amount, like $40.00, or $50.00, ... per house.
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Unfortunately, I have no idea what independent consultants are charging for this service. All my credentialing experience has been as an employee of a physician's office. Sorry.
 
Whatever you want to make per hour while handling his credentialing is what you should charge. Depending on where you live and how involved you need to be will determine the hourly rate to charge. If he just wants you to get him credentialed with an insurance company or companies, the hourly rate is going to be less than someone who is handling his credentialing, CAQH updates, re-credentialing, re-validation, getting him on staff at hospitals, hospital re-appointments, etc.

Keep in mind that there are application fees associated with some insurance companies, and hospital applications. The physician would be required to cover that on top of your hourly rate. Also, when factoring your hourly rate, include the cost to mail their paperwork. Those applications can be very thick and cost quite a bit to mail. Our office requests return receipts with each application as well.

You can also check out payscale to give you an idea of what a credentialing coordinator's salary looks like in your area.
 
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