Credentialing

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.

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.

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?

Currently awaiting for the whole credentialing process to be completed as well. They let me start working and I am basically just shadowing the MD. I'm really learning alot, but feel like I'm useless. They won't even give me computer access where I can at least see patients and complete a note and have the doc sign off on it. I wish I could help more.

I'm still a little confused by the term "credentialed" when speaking of hospitals vs insurance companies. As I understand it all it means is "verified" and approved by someone or some committee. So in the clinical setting what they mean would be you can't see patients b/c we can't bill for you seeing them. If they want to pay cash then that's a different story. Or if the physician is "on site" then they can still bill under the physician's name b/c they are signing off on your charts for the day. In the hospital you can't "practice" as an NP until they say you can which is their "credentialing department and committee" meet and vote "Yay" to get you in the club. Now, having said that (if I'm correct) I can't for the life of me understand why the hospitals take soooooooooo loooonnnnnnggggg to do pretty much the same exact thing a smaller clinic does in checking out your licenses, certs, background, etc. I got a job at the world famous "ebola hospital" but ended up taking a job with a clinic chain due to commute AND an extra long credentialing process that was dragging out 5-6 months! I was a new NP without any history to credential! I'd hate to see what happened if there was a lot to verify. Anyway, I feel your pain and stand corrected if what I've said is incomplete or wrong.

I started working in the end of February for an outpatient ENT clinic of a large teaching facility. It is mid-May and I am still waiting to be credentialed... I am seeing patients, diagnosing, prescribing and referring, but I pend all prescriptions to be signed by MD and he puts attestation on every SOAP note of mine and all services are billed under his name. I was explained that I cannot see patients and bill until the credentialing process is completed. I am not sure if it means credentialed by that large teaching facility or by Medicare, Medicaid and every major and minor insurance company out there, but I am still patiently waiting. While the surgeon was on vacations, I was not allowed to see patients since those visits could not have been billed under his name. So I just sat in the office for 2 days and read ENT books and did some research for a couple of complicated medical cases he told me to figure out (did a good job on that, so when he came back we changed their Tx plan based on my recommendations). I still got paid for those 2 days, which was nice, but it was kind of weird just sitting there in an empty office full of support stuff (2 LPNs, receptionist, surgical scheduler and office manager).