CATCH A BREAK FROM ALL OF THOSE
CREDENTIALING HITS

Everything You Need to Know about WeCredential Maintenance Service

In the video, RevCycle Partners Credentialing Services Manager Dave Kegel answers the most frequently asked questions about outsourcing your practice’s ongoing credentialing. The video helps optometry practices sort through the decision of outsourcing credentialing.

The Hidden Complexities of Credentialing a New Doctor 

Credentialing Seems Simple

But even practices that pride themselves in being on top of credentialing can find themselves floundering with one small oversight. One area practices often get tangled up in is credentialing a new doctor who recently graduated.

Take, for example, an established community optometry practice in Kansas that signed on a new associate—a recent optometry grad. Since the doctor was a new grad, the office assumed the doctor would not currently be on any of the insurance panels.

They did the next logical and responsible thing by filling out new provider applications for all of the insurances, including Medicaid.

This office followed credentialing best practices. They even did the laborious and disciplined work of following up with Medicaid every three weeks, checking the status of the doctor’s inclusion on the panels. Four months and four follow-up calls later, it seemed their diligence paid off. They received news from the insurance rep that the doctor’s application had been approved and the doctor was linked to all of the practice’s locations. The new doc started seeing patients, including Medicaid patients.

But a month later, the first EOB arrived. It was a shocker. All of the visits that the doctor had billed to Medicaid were denied.

Read the rest here.