Credentialing / Contracting Tips

[CredentialingGuru]

Most professionals aren't familiar with the credentialing and contracting side of their practice administration. I have a few tips that will give you confidence in knowing that your credentialing files are accurate and complete.

1) Know who has access to your personal information and how it will be protected. CAQH is a credentialing website that most large insurance payers access in order to credential a provider who has applied to be a part of their insurance panel. You should have a CAQH Provider ID along with a username and password. CAQH requires that your provider file be updated every three months so this is a good time to change your password.

2) NPI - Every provider is required to apply for a National Provider Identifier and you will register for a NPI with a username and password. No need to give out your username and password each time you change practice locations, just go online at NPPES.gov and update your practice location prior to your first billing.

3) Paper application to insurance companies that don't access CAQH: It's always best to complete the information under the direction of a Credentialing Specialist to ensure the application is complete. Faxing or mailing is the safest, most protected way to transmit your personal information at this time.