Account Matters Blog:

What is an Independent Physicians Association?

Posted by Daniel Ramsey on January 14, 2022

An Independent Physicians Association (IPA) is an entity owned by a network of independent physicians with the purpose of reducing overhead and establishing contracts with Health Maintenance Organizations (HMO) and Managed Care Organizations (MCO). IPAs provide independent practices the freedom to deliver high-quality, personalized care to their patients while providing resources to stay competitive.

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Topics: Credentialing

3 More Credentialing Myths

Posted by Daniel Ramsey on October 25, 2021

Credentialing, also known as provider enrollment, is often a mysterious subject for rehab therapy providers. Throughout your career as a provider, you’ve probably heard a bunch of credentialing myths that you may have taken as truth. Let’s explore some of the common misconceptions about credentialing and clarify them so this topic can be less daunting.

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Topics: Credentialing

Why Does Credentialing Take so Long?

Posted by Daniel Ramsey on March 24, 2021

Credentialing has never been synonymous with fast. Many healthcare providers get frustrated with the long wait times (90-120 days) associated becoming an in-network group/provider. In this article, we’ll explain why the credentialing process takes so long even in the digital age, so you can better prepare for opening your practice or hiring additional providers.

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Topics: Credentialing, Management

5 Things Practice Owners Need to Know in 2021

Posted by Daniel Ramsey on January 20, 2021

1. PTA/OTA Reimbursement Cut Takes Effect in 2022

It’s been a year since CMS implemented CO/CQ modifiers for services provided “in whole or in part” to Medicare patients by PTAs and OTAs. In 2022, CMS will be reducing reimbursements by 15% for services with CO/CQ modifiers.

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Topics: Billing, Credentialing, Management

Everything Rehab Therapy Practices Needs to Know About Recredentialing

Posted by Daniel Ramsey on February 20, 2020

Many rehab therapists believe that once they are in-network with an insurance panel, they are an in-network with the insurance indefinitely. This is just one of the common misconceptions of credentialing. The truth is, group and individual providers need to complete recredentialing applications periodically to remain in-network. Let’s take a closer look at recredentialing to avoid unexpected contract termination.

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Topics: Credentialing

How to: Update Surname with Insurance Companies

Posted by Daniel Ramsey on February 05, 2020

When a healthcare provider gets married and takes their spouses last name, they will update their driver's license, bank accounts, car insurance, etc. With so many crucial areas that need updating, providers might forget to notify the insurance carriers in which their employer participates. Providers must update their professional license and national provider identifier (NPI) with this change, as well as the individual insurance companies.  

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Topics: Credentialing

3 Common Misconceptions About Credentialing

Posted by Diane McCutcheon on November 06, 2019

Therapists put in years to fulfill the educational courses to become a therapist.  It is an awesome field to be in.  Just one thing about the education, the curriculum does not typically include classes on important administrative issues that are vital to a therapists starting their professional career.  Once they take and pass the exam to become a licensed therapist the search for employment begins. 

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Topics: Credentialing

3 Tips for Getting into a Closed Panel

Posted by Daniel Ramsey on October 15, 2019

What is a closed panel?

To see a patient who wants to use their "in-network" benefits, you will need to be an “in-network provider”. This means that you have been credentialed and contracted with the patient's insurance company. When an insurance company feels that they have reached the adequate number of providers for a specialty in the area, they will close that panel and no longer issue contracts for new providers/groups. This can be extremely frustrating for a new business owner. 
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Topics: Credentialing

4 Ways to Streamline Your Rehab Credentialing

Posted by Daniel Ramsey on October 01, 2019

Many healthcare providers are unfamiliar with the credentialing process because they worked in a setting in which it wasn’t required, or their employer handled their enrollment. So, it only makes sense that providers can be intimidated by the amount of work that goes into credentialing when they attempt it for their own practice. We have outlined four ways to streamline credentialing so you can start treating patients as soon as possible.  

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Topics: Credentialing

In-Network vs. Out-of-Network

Posted by Daniel Ramsey on June 26, 2019

There are many important decisions to make when starting a PT, OT, or SLP private practice. One crucial decision is whether to be in or out-of-network with insurance plans offered to members in the practicing area. 

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Topics: Credentialing

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