Provider Enrollment and Credentialing
Starting your own practice is an exciting process that may seem complicated from the get-go but we will guide you through the credentialing process and put you well on your way to success. SEE BELOW!
Don’t Forget! It’s not just the DO’s and MD’s that would need to be credentialed but rather, ANY individual who intends to sign off ANY portion of billing content! That means NP’s and PA’s as well and is a requirement for in network payment from the insurance providers.
Step by Step guide:
1. Location, location, location….. Start off by looking for a great location to open your practice.
2. You will need to Register for a Type 2 NPI (National Provider Identifier). Remember, Type 1 NPI’s are for Providers and Type 2 NPI’s are for businesses
3. You will also need to register for a bank account under the legal business name
4. Obtain a Tax ID from the IRS. If you need help an Accountant or Lawyer can provide you the information.
5. You MUST also obtain malpractice insurance for you as an individual (if this is not already complete)
6. Speak with us to start the credentialing, enrollment and contracting process
This process can be complex but we will give you updates as your paperwork progresses! See the breakdown below!
A Breakdown of the process:
The credentialing process starts with a contract that is written between Busybees and you (the Provider). We will then request you (the Provider) to submit all required documents to your assigned credentialing expert who will then start the process by submitting applications and letter’s of intent to insurance companies. Once this process is completed by the insurance company; contracts can be obtained and signed making the Provider effective in the given network!
Here is a list of everything you will need to provide! Please feel free to print!
- Documentation for Proof of: MD/ DO NP/ PA Medical School Degree
- Board Certification
- The Educational Commission for Foreign Medical Graduates / Fifth Pathway
- Drug Enforcement Agency (DEA)
- Controlled Dangerous Substance License
- Curriculum Vitae (YY/MM Format)
- State Medical License
- Council for Affordable Quality Healthcare
- Driver’s License
- Malpractice Insurance
- CP 575
- Explanation of Any Malpractice Claims
- Any Other Certifications (CPR, CMEs, BLS, etc)
Bear in mind that you can’t even apply for credentialing until you have an Employer ID Number (EIN), business location, and a phone/fax number. Once you have these things, you will be well on your way! Here is a list of everything you will need to provide! Please feel free to print!