Posted by medpro | Posted in Credentialing, Medical Contracting, Physician Credentialing, Physician Review, Provider Contracting, Provider Enrollment | Posted on 18-10-2010
Welcome to a blog created to furnish a venue for interested parties to exchange information, news and notes about what can sometimes be an overwhelming subject…. Provider Enrollment…. That is getting all manner health care providers credentialed and contracted with the dizzying array of insurance entities. A list of which runs the gamut from Medicare/Medicaid oriented government entities to the large commercial firms like Aetna, Cigna, Blue Cross/Blue Shield, Humana and UnitedHealthcare to a plethora of HMO’s and PPO’s and all manner of organizations in between.
For anyone who has attempted to undertake a contracting or credentialing effort they know what an complex, frustrating and time consuming activity it can be. Each insurance entity has it’s own unique network needs, processes and procedures. Some make it simple and easy and have excellent network management representatives while others make it a bit more difficult. Add the possible variations together and you end up with a mind boggling amount of work, time, phone calls and, not too infrequently, frustration. Not for the faint of heart.
What we hope to accomplish is to provide you with general data and information that you’ll find helpful and relevant to and during the provider enrollment process. It addition we hope to offer you info and insights that will help enhance the interface with your own payor universe.
I’m sure we don’t have to tell you that the healthcare industry in a state of flux. As a consequence it has never been more important to insure that your relationship with the public and private payor community is strong and clear. All of that begins with the proper approach to contracting and credentialing. So come on along. Bookmark this site or subscribe to the RSS feed, contribute to the comments page, contact us with questions or topic suggestions. The fog of confusions is only dispersed by information and dialogue.