How Long Can Physician Credentialing Process Take?
Credentialing Corner | Jan 03, 2017
This is the most common question asked by the clients who avail our credentialing service: What is Physician Credentialing Process? How long will it take to process my application? But this as whole is dependent on many variables that ultimately decide the timeline, and the most importantly it depends on the type of enrollment you are seeking.
Credentialing is a systematic process of verifying healthcare provider’s educational documents, certifications, experience, competence or status of the current licensure. Hospitals, employers, and insurance carriers require this background check to decide about provider enrollment.
The credentialing process can take a lot of time because it involves extensive documentation in the first phase and secondly it depends on how long the payor or carrier would take to analyze your application. Getting enrolled with Medicare is faster as compare to commercial carriers. Enrolment with Medicare takes up to 40 to 60 on average. However, getting registered with commercial carriers can be tedious and can take up to 90 – 120 days on average.
There are some other dependencies too that can prolong the process. For instance, in some states, physicians must wait for 60 days to submit their application after the completion of their certification. In some states, this is limited to a 30 days period.
Beware that without getting registered and new physicians are not allowed to see patients or provide any type of medical treatment. Practices cannot bill for non-credentialed physicians and doing so can result in denial of the claims submitted on behalf of that physician. Sometimes, practices submit claims of a non-credentialed physician in the name of an already credentialed physician. It can cause many problems if found during the audits and can open up legal investigations. In this way, non-credentialed physicians remain unprofitable for the practices. It emphasizes an early start of the new physician credentialing process.
How to Speed Up Physician Credentialing?
Incomplete documentation and missing information are among the major causes that delay the credentialing process. Submitting the application by verifying every aspect and requirement expedites the enrollment process and eliminates unnecessary delay caused by resubmissions. Credentialing experts at Sybrid MD have mastered the process and can maximize the success ratio by systematically handling the application.
It is of immense importance to keep all the documents ready. It includes CV of the physician along with education diplomas & certificates, board certificates, licenses. Moreover, details of the privileges, National Provider Identifier (NPI) and may also include valid Drug Enforcement Administration certification. Collecting the right documents is just the first phase and which completes with the submission of the application. In the second phase, the application verification process starts from the carrier’s end, and in the last phase, the application is approved.
Sybrid MD offers a quick credentialing process that enables healthcare providers cut the time-consuming process through an organized and efficient service. We have already simplified this process for thousands of healthcare organizations and healthcare workers. We'd process all applications and official procedure on your behalf, contact our credentialing professionals or feel free to give us a call at (888) 312-6847.