MAKE NOTE OF THESE IMPORTANT CHANGES TO CREDENTIALING FOR 2020.

By Jon Kettner

For many optometry practices, the new year is a time when practices ask, “What are my growth goals?” Growth, of course, is tied to healthy revenue cycle management. The new year is the perfect opportunity to make sure you’re aware of changes to credentialing in your state. Below are some changes to credentialing to make note of for the new year.

• If you want to add another insurance, the average insurance turnaround time is 90-120 days. Start the process now.
• Did you check if any of the big employers in your area changed who they will use for vision benefits? Now is the time to check, so you’ll be ready to serve your patients.
• Illinois Medicaid is now sending vision claims through Avesis. Make sure you are credentialed with Avesis. If you are not credentialed with Avesis, you won’t get paid for routine vision services through Medicaid.
• NC Medicaid recently granted five contracts for MCO:
  • UHC uses March Vision;
  • AmeriHealth uses Caritas;
  • Carolina Complete uses Envolve;
  • Wellcare uses Superior; and,
  • BCBS uses Eyemed.

Make sure you and your practice are credentialed with the correct product of each of the plans.