Account Matters Blog:

Credentialing: A Matching Game

Posted by Daniel Ramsey on July 12, 2018
Daniel Ramsey

Once you begin the credentialing process for your new business, you’ll discover that the insurance companies have a long list of required documents that you will need to submit in order to verify the legitimacy of your business. One of the biggest issues that we run into when credentialing a client is that the information on these documents do not match. That’s where the trouble begins…

The most important documents when enrolling a new provider group is the IRS CP 575 form, Professional/General Liability Insurance, and a Business License. We can’t emphasize enough how important it is that each of these docs have the exact same information, such as business name and address. If they do not, you risk the chance that your application will be denied and you will have to begin the process all over. 

We often encounter eager owners who have set up their Tax-ID or purchased liability insurance before they lease a space or even settle on a business name.  Owners aren’t doing the wrong thing by trying to be proactive, but changing information during the credentialing process can lead to lengthy delays. If you have to make a change while your application is processing, you MUST go back to the source and update this information, or your application will be denied.

Medicare is the most notorious for requiring matching documentation. If your business name on the IRS CP 575 is “Top Notch Physical Therapy, LLC” but your check says, “Top Notch Physical Therapy LLC” they will send the application back for correction which can significantly delay the process.  Yes, it is just a coma but Medicare is a stickler for details, and they are not the only one…

Credentialing is a difficult and time consuming process when everything is correct.  Any missteps can easily derail the process and leave you waiting for weeks or even months for problems to be corrected.

Don’t risk this happening to you.  Check that your documentation is spot on or better yet, hire Account Matters to credential your business.  We are experts in the field and can identify any issues before your applications are submitted ensuring you get in-network as quickly as possible.

Topics: Credentialing

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