Credentialing is a key piece to any practice or hospital. If providers are not properly credentialed, they will not be paid for their services. Credentialing is a long, comprehensive process that requires consistent follow up and attention to detail. Many practices and hospitals outsource this process, and Legacy Consulting is glad to assist!
What you need to know
Credentialing is a slow process. The fastest payors can credential in 45 – 60 days. Some take as long as 180 days! The earlier you start the process, the better. This ensures your provider is able to see patients with all types of insurances starting day one. Legacy uses online and electronic methods for as many payors that allow it to ensure faster processing of credentialing applications.
What you need to have
There is a rather long laundry list of items you will need handy for your provider. The most important two pieces, however, are a PECOS login (if the provider plans to see Medicare patients) and a CAQH login. CAQH, or the Council for Affordable Quality Healthcare, is a consolidated site that does take some time to put together, but once complete, many payors will simply access this profile to initiate the credentialing process. There are even some payors now that will not credential without a CAQH ID number.
Between these two profiles, we will most likely have nearly everything we need to get started. Additional items needed may be the provider’s CV or resume, license or certification copies, all current PTAN numbers for both the provider and the practice, a W-9, and more. Legacy provides you with our proprietary Credentialing Questionnaire when you on board to give you a handy guide to everything that will be needed to fill out applications.
What you can expect
Legacy has detail oriented credentialing specialists that will make sure every “i” is dotted and “t” is crossed. We will also make sure to research your state’s requirements if we have not credentialed in your state before to ensure we are meeting requirements. We will follow up with every payer at least every two weeks, or 3-4 depending on the payer’s time table. We keep a tracker of our progress with every call made and every reference number available and can provide that to you at anytime so you can see our progress.
Remove the administrative burden from your staff and let Legacy Consulting Services handle your next credentialing project for you!