3 Common Provider Enrollment Mistakes to Avoid

1. Starting Too Late

Many practices get started on the provider enrollment process too late, which can be a matter of success and failure for a new start-up practice.  You would want to begin the process at least 90 days prior to opening (with the exception of a provider already joining an existing practice).  For a new start-up, outsourcing the work to a credentialing company, can take at least 4 - 6 months to complete the entire process, doing it on your own could take 8 - 12 months.  Payer enrollment is critical to your revenue.  Start early!

We can help you start here

2. Forgetting to Include Complete Information

An insurance company needs a complete picture of the provider’s current and past medical practice info to get the provider credentialed.  Requested data usually includes practice address, phone, fax, contact information, specialty, copies of your licensure, employment history, any current or past malpractice history.

Omitting any of this data can lead to delays in your provider credentialing, and it can sometimes be grounds for a denial.  Forgetting to sign the applications and contracts can cause significant delays.

Using a credentialing service will ensure that your information is complete. We can help you do this here

3. Lack of Follow-Up

 Regular contact with the payers will keep you up to date on your application's status.  Being proactive is your best weapon.

Working with a credentialing company can help you complete each phase without unnecessary delays. They can provide you assistance with both government-based and private insurer applications as well as any CAQH and NPI requirements. Check out our website for help with all things credentialing


-Sherry O'Bray

Sherry 2

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