Wiki Adding a new physician to a group practice

[dmturner609]

I am new to the physician credentialing area. Our office is located in Indiana. Right now we have one physician in our Group. We are going to be adding another physician and since I have been asked to add Dr B to our Group NPI and Tax ID I have some questions and need to find out what the requirements are.

Dr B is currently contracted with Medicare and most of the insurance companies that our group is and he has his own provider ID's with these insurances. He will start in our office by seeing patients one day per week and then gradually join our group full time. In the meantime, he will still be seeing patients at the group that he is currently with. I do not want to stop his reimbursement with his current group, but I need to add him to our group so that he can start seeing patients at our office and make sure our group reimbursement is appropriate.

Can somebody please let me know how I would go about starting this?

Thanks,

Denise Turner

 

[YCastleberry]

The reimbursement for the other will not be affected during the credentialing process which is a lengthy process. As you know the process will start with Medicare. The provider should not see any patients with coverage the requires the provider to be credentialed with them. Communication with the clinical staff during the credentialing process so they are aware of the effective date so they can start scheduling those patients with the provider. Effective dates are not retro'd so it is important to communicate this to the provider and clinical staff.

 

[Chelle-Lynn]

Medicare will be a relatively simple process to update the provider. He will need to log on to his PECOS account and add your office as a new site of service (in addition to his current group) and he will need to ensure that he assigns his benefits (payments from Medicare) for your office to your site for reimbursement (this will direct the payments for your office to you instead of to the provider). In most cases adding a new site to Medicare will not take the full 3-6 months. We generally see turn around in as little as 1-2 months.

In regards to the other carriers, you will need to reach out to them for their processes on adding a new provider to your site. Generally most carriers will have their own internal process for completing his credentialing for your office.