WCH Service Bureau WCH Service Bureau
  • Services Services
    • Medical Billing
    • Provider Credentialing
    • Medical Auditing
    • Real-Time Eligibility
    • MIPS Support
    • Webinars
    • Practice Analysis
  • Products Products
    • Credentialing Application ©
    • iSmart EHR ©
    • PMBOS ©
    • Time Management Program
  • WCH Franchise
  • Company
    • About
    • Our Offices
    • Careers
  • News
    • WCH Insights
    • Healthcare News
    • WCH News
  • Contact Us
  1. Home
  2. > WchNews
  3. > WCHNewsItem
Phone: 888-924-3973 Subscribe Pay Now iSmart Login Technical support

How do I know what insurance companies I am credentialed with?

5/28/2017

How do I know what insurance companies I am credentialed with?

 

Question:

Hi Jennifer,

I am leaving employment at a place where I was an in-network provider for certain insurances, but I'm not exactly sure which ones.  I signed something when I started working allowing the employer to credential me.  How can I find out which plans?  

Thanks,

Dr. P

 

 Answer provided by Jennifer Kirschenbaum, Esq:

 

It is pretty typical to give an employer the right to credential you with insurance carriers.  It is also required by law in New York that employers promulgate to patients the insurance a doctor takes:

www.health.ny.gov/regulations/publichealthlaw/surprisebilllaw/emsandsurprisebillslaw.faq

1. How does Public Health Law §24 prevent patients from getting surprise bills?

•  Subdivisions (1) through (2) apply to health care professionals in private practice and diagnostic and treatment centers, including health centers under 42 USC §254b. Diagnostic and treatment centers are health care facilities licensed under Public Health Law Article 28, including clinics, dialysis and ambulatory surgery centers.

•  Under subdivisions (1) and (2), health care professionals in private practice and diagnostic and treatment centers are required to disclose to patients or prospective patients, in writing or through an internet website, the health care plans in which they are participating providers and the hospitals with which they are affiliated, and verbally at the time an appointment is scheduled. If they do not participate in a patient's health care plan, they must upon request from a patient inform the patient of the estimated amount they will bill absent unforeseen medical circumstances that may arise.

5. What types of health care professionals does Public Health Law §24 apply to?

Any health care professional in private practice that is appropriately licensed, registered or certified pursuant to Title 8 of the Education Law. These health care professionals would include, but not be limited to, physicians, dentists, nurse practitioners, nurse midwives, podiatrists, mental health practitioners and physical and occupational therapists.

So, the employer should have a list pretty handy.  You also would likely be signing paperwork related to the credentialing process, and I have to point a finger your way. Why were you so cavalier during the process not to take note of insurance you take?  Being a credentialed provider means you, the doctor, are agreeing to operate in accordance with plan requirements—and you may be signing off elsewhere onto potential liability as a participating provider should you fail to adhere to certain standards...  

Going forward, I highly recommend paying a bit more attention—reading more fine print, and maintaining an ongoing list yourself of where you are credentialed.  An employer credentialing you is worried about patient accessibility to an in-network provider and revenue. A credentialed  provider should be worried about the former, but also what liability they are potentially signing on to. These are very different concerns.  

If you left the prior place a while ago, or for some reason a list was not maintained, you may be forced to contact the carriers individually to confirm credentialing. Hopefully, that is not the case.   

Hope this helps.   

Read more news
Liked the article? Share with friends:

WCH News

January 18, 2023
WCH Accomplishments 2022
AT THE BEGINNING OF THE NEW YEAR, IT IS CUSTOMARY TO  SUMMARIZE THE RESULTS OF THE PREVIOUS ONE. WE THANK YOU FOR YOUR TRUST AND SHARE OUR ACCOMPLISHMENTS WITH YOU.Creden...
December 26, 2022
Professionalism is Not Afraid of Obstacles
Professionalism is Not Afraid of Obstacles WCH is always happy to share its success stories with you. This month, we want to feature a recent story about the journey of our pharmacy specialty cus...
November 07, 2022
NEVER STOP LEARNING
“Education is the most powerful weapon which you can use to change the world”, Nelson Mandela. We are glad that people who gathered at the WCH team share this opinion and are proud that th...
August 09, 2022
Introducing WCH CredyApp
Introducing WCH CredyAppWCH Credentialing team knows all challenges of handling credentialing internally. WCH has done credentialing for over 20 years, helping healthcare providers of various specialt...

Healthcare News

January 18, 2023
Get $26,000 per Employee with Federal ERC Credits
Get $26,000 per Employee with Federal ERC CreditsLike the PPP/EIDL, there is no repayment as it is a tax credit of up to 26,000 per W-2 worker you employed in 2019/2020.It is no secret that the Corona...
December 26, 2022
Cuts in Physician Payments Will Reduce Access to Care
Cuts in Physician Payments Will Reduce Access to Care The MGMA’s data shows that 90% of medical facilities reported likely declines in access to care following the 2023 payment cuts in the ...
November 29, 2022
LockBit Ransomware Campaign: New Suspect
Lockbit ransomware campaign, the variant that has been known to target healthcare in the past, is back on the radar. Thus, the Department of Justice reported that on November 15, 2022, the alleged cha...
November 04, 2022
Warning about the threat of imprisonment for breaking the HIPPA Law
If prosecutors find that providers disregarded PIR (protected information rules) in a way that warrants more punishment than fines and penalties - the doctor faces up to a year in prison on charges of...

Ready to start?

Contact Us
linkedin
⟶ let's start
WCH Service Bureau
Payment options
WCH Service Bureau WCH Service Bureau WCH Service Bureau WCH Service Bureau WCH Service Bureau
Pay Now
Services
  • Medical Billing
  • Provider Credentialing
  • Medical Auditing
  • Real-Time Eligibility
  • MIPS Support
  • Webinars
Products
  • Credentialing Software ©
  • iSmart EHR ©
  • PMBOS ©
  • Time Management Program
Company
  • About
  • Contact Us
  • Careers
News
  • WCH Insights
  • Healthcare News
  • WCH News
Support
  • Feedback
  • Technical Support
  • Privacy Policy
888-924-3973
3047 Avenue U, Brooklyn New York 11229
Fax: 347-371-9968
Follow us:
2023 WCH Service Bureau, Inc.® | Web Design and Programming by WCH Service Bureau, Inc.® | Privacy Notice
Can I help you?
Anna
Anna
Administrative Assistant
Hi, what service does your question relate to?
Medical Billing
Provider Credentialing
Medical Audit
Franchising
PMBOS
iSmartEHR
Eligibility
MIPS Service
Other
What are you interested in?
Let me help you.
Please, leave your contact details and we will answer your question.
Thank you for your request, we will respond as soon as possible.
Let us Help You

Dear Provider,
WCH can help your practice in your credentialing needs! Using a credentialing specialist with the knowledge, expertise and connections that can help position your practice ahead of time. Let us help you today! During credentialing process WCH becomes your external credentialing department for all communications, submissions, follow up and any other questions that will come up during the process.

WCH Specializes in:

  • All individual Medical specialties
  • Mobile IDTF
  • Single & Multispecialty Groups
  • Urgent Care, Labs, DME, Pharmacy
  • Article 28, 32, 31
  • Revalidation, Reinstatement &
  • Exclusion
We help Providers in All States! WCH provides Clarity, Comfort and Security in your Practice.
Let us Help You
Wch SErvice Bureau

Medical billing services offered by WCH Service Bureau go far beyond the usual understanding of billing.

 

What we offer is not just excellent professional billing and collection services. We also stand as guardians of your reimbursement and compliance with federal, state laws and regulations as well as private insurance policies and procedures.

 

Do it right! Do it with WCH!

Let us Help You
Wch SErvice Bureau

Periodic medical chart auditing is vital for any healthcare provider and medical practice. Let the professionals evaluate your coding, billing, and documentation practices! Our auditors are AAPC-qualified CPMAs (Certified Professional Auditors) and CPCs (Certified Professional Coders). We perform comprehensive Chart Auditing. We can do the following services for you:

  • Identify areas of risk leading to upcoding or downcoding and medical coding accuracy;
  • Ensure that coding practices are compliant with the regulations set forth by private and government payers;
  • Evaluate Incident to guidelines and services performed on collaborative premises;
  • Perform Analysis of Denials/Duplicate billing /Appeal process/Modifier usage;
  • Review Front Desk work including but not limited to: Eligibility verification/Benefit maximums verification/Excluded services verification/Authorization process/Patient responsibility (deductibles, copays, coinsurance)/Coordination of benefits;
  • Evaluate Insurance plans participation and consistency of contracted rates;

Do it right! Do it with WCH!

Try WCH PMBOS
Request information
Perfect! Please fill in the form

What service does your question relate to?

Let us Help You
Wch SErvice Bureau

Do it right! Do it with WCH!

REQUEST FREE DEMO
Planned number of Providers : *
Specialty : *
Job Role : *
Perfect! Please fill in the form
Perfect! Please fill in the form
Have any questions? Please contact us practiceanalysis@wchsb.com
Leave us a feedback
 
Thank you
for your feedback!
Wch SErvice Bureau

Thank you for your interest in our company!
Our team will process your request and will respond as soon as possible during regular working hours.

Subcribe
Subcribe Subcribe
 
Our site uses cookie.

This site uses cookies for analytics, personalization and advertising. By continuing to browse it, you agree that we use of cookies. To find out more or change your cookie settings click here.