Cracking Credentialing : PTs, OTs and SLPs need to know about insurance credentialing

Doing business yourself means freedom and your own boss. It makes you in charge for running a practice and daily tasks of office. One other aspect is to get your practice credentialed with all major payors. At the end of the day cash flow plays a crucial role in running your practice successfully. 

Get In Network

Getting Credentialed on the panel of insurance payors requires filling application and continous follow up. Its a long process of submitting application with required documents and then continous follow up with insurances till the time we get provider id. 

Why it is so Important to get Credentialed ? 

Well there are many perks of getting in network like referral of new patients by insurance network, become primary care provider for patients and create a base for practice in long run. 

Credentialing also gives protection to individual providers. Here are some initial steps for credentialing application

  • Get a Tax Id
  • Malpractice Insurance
  • Get NPI number
  • State License to provide services
  • Find practice location
  • Signed W-9

Keep Trying with "Closed" Insurance panels

Credentialing is a time consuming process and after all your efforts on initial application you get the result of rejection from insurance panels you have to keep trying with insurance panels. You have to keep sending your applications to payers and same process repeats again. 

As everyone says “Its not that easy ride but at the end its all worth it”

Keep trying and usually insurance panels open up based on specialties and time is essence in the whole process. 

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