credentialing

  1. K

    Question New NP & POS

    I just started working for Primary care and I need some help with the Billing and POS for a New NP in a different location. In the process of hiring a New NP and she will be in a different location 1. New NP A she will use an OBGYN clinic on Wed and Thurs... The OB is closed on Wed...
  2. S

    Provider moving practice location

    Hello everyone! We have a provider who left her previous practice, and is joining ours. We bill everything with our group NPI and tax ID, but individual NPI as rendering. We are in mental health, and she is our first prescriber (DNP). Everyone else at the practice is LPC, MSW, or LP. She is...
  3. C

    Out of network billing!!

    Hello! Our practice just became in network with UHC as of June. Our effective date was 6/22/18, there was miscommunication with the rep from UHC and the person in our company who signed the contract. The person was under the impression that once the contract was signed and submitted back to the...
  4. E

    New provider credentialed but not associated with our practice yet

    We have a new provider that left a local practice to join ours. He is credentialed with the insurances but is in the process of being credentialed with our practice. No one told me his credentialing was incomplete so I've been billing under his NPI w/our tax id# since he started. We are...
  5. C

    New provider not credentialed with health plans

    Hi there, We have a new provider (an MD - not an NP) who is not quite credentialed with all the health plans our practice participates with. When she sees patients who have an insurance she is not credentialed with, I have been directed to bill those claims under another physician at the...
  6. S

    Credentialing question

    We have had some issues getting credentialed with Medicare. Our group effective date is 7/31/17, but our provider(we only have 1) is not assigned to the group effective until 10/1/17. Does anyone know of a way to get the claims from 7/31/17 to 9/30/17 processed without the providers name on the...
  7. C

    Contract Billing and Credentialing from Home

    Certified Coder and experienced billing and credentialing from home. Current knowledge of navigating current, complicated billing procedures and guidelines. Would love to talk to small, independent practice. If in the Dallas area, would be available to meet regularly in the office.
  8. C

    CMB Healthcare Consulting

    CMB Healthcare Consulting is a sole proprietorship based in Annapolis, MD. We strive to provide accurate, efficient, and effective assistance to medical providers and facilities who need help navigating the confusing and tedious world of insurance credentialing. CMB Healthcare Consulting has...
  9. D

    Taxonomy selection

    I am an office manager for small ENT/audiology practice in Texas. The doctor is listed with NPPES as group-single specialty. As I add the audiologists to her contracts, does that change her to group-multi specialty? If so, how do I go about changing her status with NPPES? Thanks!
  10. S

    Provides Under Same Tax ID/Different Location Not Credentialed

    All providers are under the same tax ID number. One doctor sees patients at another location, this doctor is the only provider credentialed at that location with BCBS. The example: Doctor #1 sees patients at location A and B. Doctor #2 only sees patients at location B. Doctor #1 was out...
  11. D

    Question regarding NP and covering a doctor while on leave

    Hello all, I have a doctor taking a medical leave and I am working with a locum tenens recruiter; they employ the NP. My question is, in order to direct bill does the NP have to be credentialed first or would we just bill under our doctors NPI? (The NP is paid by the recruiting company) I...
  12. K

    Credentialing and Proper Billing

    My practice is merging with a larger practice on 03/01/2016. we were told this last week...the incoming practice is saying that our Therapist who will remain for the next few months will still be seeing patients however we must bill under a therapist that is already credentialed to the new...
  13. T

    Independent Billing / Credentialing

    Hi All, I'm seeking tips on how to start up my independent billing and/or credentialing business. I've obtained my CPB from AAPC and want to work with new and/or private practice physicians. Any other info on software would be a plus as well. Your responses are welcomed and appreciated! Thanks!
Top