Posts by Adam
Credentialing with Blue Cross Blue Shield
Navigating BCBS credentialing can be quite complex due to its state and provider type specificity. Let’s delve into the nuances… In various states, BCBS goes by different names. Here are a couple of examples: BCBCS in the following states is called Anthem: CA CO CT GA IN KY …
Read MoreAetna- how to credential
In recent years, Aetna has undergone significant changes in its credentialing process. This article aims to outline the current procedure. Medical and Mental Health providers can now conveniently submit their applications online through the Aetna website. Upon submission, Aetna generates a unique Request ID#, which is also sent to the provider via a confirmation email.…
Read MoreCAQH Portal and Its Role in the Credentialing Process
A Provider’s CAQH portal plays a crucial role in the credentialing process. Let’s delve into its specifics. For Traditional Medicare and Traditional Medicaid credentialing, the CAQH portal is not utilized. Providers can undergo credentialing with these payers without a CAQH profile. However, Commercial, Medicare Advantage Plans, and MCO plans require providers to maintain an active…
Read MoreHow long does the credentialing process take?
At some stage, every provider accepting insurance has expressed frustration with the credentialing process and the seemingly endless waiting time for insurance approvals. We understand your frustration. Now, let’s explore the different processing times. Medicare typically advises allowing up to 120 days for application approval. Nonetheless, Rush Credentialing consistently receives approval letters from Medicare by…
Read MoreOrganizational NPI #- When Do I Need One?
Let’s discuss the different NPI #’s and when each one is appliable. An NPI (National Provider Identifier) is granted via the NPPES website (National Plan & Provider Enumeration Systems, Link: https://nppes.cms.hhs.gov/#/) to healthcare providers, and typically to the healthcare practice as well. This identifier remains with the provider or practice for the duration of their…
Read MoreMedicare Credentialing- The In’s and Out’s
Medicare seems to make life difficult for providers nationwide when it comes to credentialing, regardless of your provider type. Luckily, Rush Credentialing is ready to give you some tips. Here is a list of the different provider enrollment applications we will be focusing on: 855I Application 855B Application 588 EFT Application 460 Par Agreement These…
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