Credentialing

  1. Hello everyone,

    i am am looking for some assistance. I recently graduated NP. I accepted a position but have some questions. Originally they stated I'd be paid in full (right now I'm hourly at a discount rate) when my license came in. That came apx a month ago and they keep saying I need more and more things. First APN, then NPI, latest DEA. I need to know what exactly I NEED to see patients. I have a RN, NP, State controlled drug license, DEA, and NPI. They are now stating I need to be credentialed because I still cannot see patients on my own. I'm curious if this is true or if my notes could be co-signed at this point. Any input would help! Thanks.
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  2. 7 Comments

  3. by   traumaRUs
    Are you working in a hospital or private practice office? If hospital, yes you need to be credentialed and at least in my area (I'm credentialed at 3 hospital systems), credentialing can take up to 6 months as it depends on how often the hospital credentialing board meets for mid-level providers.

    If private practice, don't they have a clerk to do this?
  4. by   msufan3710
    I'm currently dealing with this right now. The credentialing process at long term acute care centers has taken 2 months and the acute care hospitals are still pending. The SNFs are either immediate or 1-2 weeks.

    to answer your question- yes you need to become credentialed.
  5. by   TicTok411
    My credentialing took about three months. I think they also deal with getting you covered by medicare and all the insurance plans so you can be reimbursed for patients you see. So, it is kind of important and something we all go thru... It also makes it tougher to job hop as the process takes so long.
  6. by   Xcbanditbravo
    I understand it's something I'll need. But can I see patients and rx meds then bill under MD who is in office. Also isn't there a period of time I can hold billing and bill after insurances credential me?
  7. by   elkpark
    Quote from Xcbanditbravo
    I understand it's something I'll need. But can I see patients and rx meds then bill under MD who is in office. Also isn't there a period of time I can hold billing and bill after insurances credential me?
    If you're talking about seeing people in a hospital and billing under the physician in the office, the hospitals for which I've worked in the past just won't allow you to come into the hospital and see people, regardless of who is or isn't billing, until you've been credentialed. I got hired as a psych CNS to work for the psych C&L service that is contracted to provide services in several of our local hospitals, and I still had to go through the separate credentialing process for each of the hospitals in the system in which we consult.
  8. by   juan de la cruz
    Quote from Xcbanditbravo
    I understand it's something I'll need. But can I see patients and rx meds then bill under MD who is in office. Also isn't there a period of time I can hold billing and bill after insurances credential me?
    If you're practicing in an in-patient setting, hospitals won't let you see patients and order anything without being credentialed as a provider. In some places, they may say you can function as an RN if you're not credentialed yet. That means you can only see patients as a scribe (i.e., on your notes, you are not documenting physical exam, assessment and plan) and write your orders as a verbal order from the physician you work with. Without the ability to see patients as a provider, you can't bill for services as a provider.
  9. by   WKShadowRN
    I signed my contract in November and my first day of orientation is April 3. Everything must be in place before a provider is fully credentialed. As it is my first NP position, it took longer (complicated by the fact I paid out of pocket for my DEA, DHEC, etc., but that is reimbursable by my CME allowance.

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