A Reminder for Healthcare Providers to Do Credentialing and Enroll with Medicaid

Dear Healthcare Providers,

At the beginning of the new year, we would like to remind all providers to make sure that your credentialing is in order. If you have moved or you are planning to make any changes to your credentials, please make sure that all insurance companies are aware. If you are planning to hire providers into your groups, make sure that all of the new providers are added to the practice. The same rule applies when you are terminating providers— please inform insurances of their terminations.

The WCH credentialing department can help with all of these requests for your practice. 

Here are a few more reminders that are important to remember and to follow:

• Please keep in mind that Century 21 Act still requires providers to have Medicaid participation to be eligible to enroll with Medicaid Health Plans. It means that any healthcare provider that will be providing services to Medicaid-managed health plan patients requires to have Medicaid enrollment first before they can apply to Medicaid health plans.

• WCH can help your practitioners to become Medicaid certified within two months. The managed care credentialing process can start right after the Medicaid approval.

• Finally, the most talked-about topic are providers that are not credentialed with insurance companies providing services. The law regulates that the insurance company must credential any healthcare provider that provides services. Any time the practice hires new providers, those providers must be credentialed with the insurance. Their individual NPI cannot make any referral without a proper credentialing taking place. Fortunately, WCH can help in the fastest time to credential new providers under the group.

Please speak to our department about your practice credentialing needs.