Prospectively Healthy is proud to offer credentialing services for healthcare professionals.
What is the process for credentialing?
There are several phases of the credentialing process, and we are willing to help you with as many or as few of them as possible. Here is how we categorize the process:
Preparation: Gathering information about the provider to begin the credentialing process
Selection: Selecting which insurance companies to credential with from the list on page 3
Contact: Creating a contact person with the insurance companies for submitting documents
Initial Submission: Sending over necessary paperwork for credentialing to each of the insurance companies discussed
Subsequent Submissions: Sending additional requested documents, clarifications, etc, to the insurance company as they request them.
Follow Up: Calling each contact at 30, 60, and 90 days to ensure the process is still in progress, and making sure no additional information is needed.
Finalizing: Finalizing all contacts, creating a document of passwords, website and portal logins, and a PDF copy of all documentation provided along the way
Re-Credentialing: Many insurance companies require you to renew your information annually, or in set intervals. If you have already credentialed, and need help completing the re-credentialing process, please make sure to provide the requests from the insurance companies.
What will it cost?
Hoping to be upfront and honest, we have created out best estimate on the costs associated with credentialing. Please note these time periods are estimates. Each company and experience is different, and your credentialing could take more or less of this time. Preparation, Selection, and Finalizing are total hours (not per company), but the Contacts, Submission, and Follow Up will multiply with the number of insurance companies you select.
Hourly Rate: $40
Preparation: Flat Fee of $75
Selection: Flat Fee of $50
Contact: 30 Min per insurance company
Initial Submission: 30 Min per insurance company (plus time to contact you and complete additional documents)
Subsequent Submissions: 1-3 Hours per insurance company
Follow Up: 1-2 Hours per insurance company
Finalizing: Flat Fee of $50
(Re-credentialing versus initial credentialing does not change the time allotments, but it does cut out processes such as Selection)
Estimates: 1 Company: $200- $275 3 Companies: $250-$325 5 Companies: $500-$550
What insurance companies do we help with?
The credentialing world holds a similar skeleton for most companies. The following are companies that we have worked with several times over again. If you do not see a company listed, it simply means it might take some additional research to begin the process. It is not an indication that we will not be able to successfully credential you.
- American Specialty Health (ASH)
- CHP (Kaiser’s Alternative Care Plan)
- Blue Cross Blue Shield (Anthem, BCBS, Blue)
- Health Net
- United Healthcare
Please note that I do not credential individuals with Medicare, or Medicaid. However, I do credential with individual state plans where applicable.
A word from Jessica:
First and foremost, thank you for trusting me with your practice. My work is largely based on referrals, and so your word is everything. Please feel free to discuss any concerns you may have along the way, and spread the word of my business to your fellow colleagues. I currently provide services for Physical Therapists, Naturopathic Physicians, Massage Therapists, Chiropractors, and Acupuncturists.
If you would like to begin the credentialing process, or would like a free 15 minute consultation about credentialing, please contact us at firstname.lastname@example.org.