Credentialing Application
Frequently Asked Questions
1. Is it difficult to use the credentialing application software?
Not at all! Our credentialing software is user friendly and is designed with you in mind. Instead of spending days completing insurance applications, our credentialing software allows you within twenty minutes to generate multiple applications. WCH cares and wants to give you time back to concentrate on what you love to do best: care for your patients.
2. How long does it take to become a credentialed provider?
If you are using the WCH credentialing application, the process can be completed within a three month frame after submitting your application
to the insurance.
3. Can I begin seeing patients without completing the credentialing process with an insurance company?
This depends on the patients’ insurance plan and benefits. Each patient has a specific health plan coverage that delegates the reimbursement and eligibility requirements. Nevertheless, the doctor is financially responsible for seeing the patient prior to checking patient benefits and insurance credentialing requirements. From our experience, we can say that the majority of insurance companies prefer to pay contracted providers.
4. What does the credentialing process entail?
The credentialing process involves gathering of documents, completing correctly applications, mailing the package, numerous phone call for follow up status, site visit and all other additional hassles that comes with insurance credentialing compliance process: which can take normally from 3 months and with delays up to 8 months. It becomes vital to choose the right company for the job.
5. What happens if the insurance company returns the application back?
Insurance companies return the applications back to providers for different reasons, mainly due to missing documents, incomplete application or the inability to adequately verify the information specified by the doctor. Upon receiving the returned application, the provider is required to provide the insurance company with the necessary documentation within a given time frame. In many cases, the provider is required to complete a new application and resubmit it for process. Having an experienced company like WCH completing the credentialing process on your behalf will reduce the unnecessary work, saving time and money for you.
6. How long does the credentialing contract exist between the insurance companies and doctor?
Once the credentialing application is approved, the doctor is considered a participating provider. Every three to four years, the insurance company will resend the credentialing documents to the office of the provider to update the current information that they have on file. The process takes between 30 to 60 days. It’s important not to miss your credentialing deadline; otherwise your contract with the insurance company could be cancelled. If you are using our credentialing services, we will inform you of your upcoming re-credentialing dates.
7. Are insurance applications listed on this site standard for all states?
No, not every insurance company provides the same applications for all states. It is important to contact insurance companies in your state to request the appropriate application. By choosing the Package III billing plan, we will gather the necessary applications for your practice location and submit them
directly to you.
8. Can an application submitted guarantee acceptance into the insurance network?
No, submitting application to the insurance does not provide guarantee that insurance will accept provider into the network. Before submitting the application it is important to find out if the panel is open for the provider specialty. Once the confirmation has been received the provider can submit application. If you are just starting out your practice or just need assistance with contacting the insurances, feel free to choose Package III – V.
