Physical Therapist Credentialing Services
House of Outsourcing helps practitioners and their staff with the Physical Therapy credentialing process as part of our practice management solutions for start-ups. You are free to focus on your business if you leave all the paperwork and time-consuming calls to our experts’ credentials. We are here to accept this burden with our credentials services you and your field office staff.
Our private practice credential team is specializes in physical therapist, occupational therapist, and speech therapist credentials. These services include group contracting, supplier additions, Medicare registration, tri-care registration, Medicaid registration, commercial insurance registration, and all other US’s insurances.
Benefits Included in House of Outsourcing Credentials
• Experts in private practice handle all your credentials
• An extension of your team to acquire the necessary documentation
• Alerts are sent bi-monthly for credentials
• More time to take care of your patients and employees and leave us with paperwork
• All forwarded and finalized forms have access to the clinical database
Is it important for therapists to get credentialed?
If you work as a therapist in a primary clinic or hospital, you are usually allowed to bill insurance to patients since your organization is on the right panels. If you quit, you may realize to your dismay that you lack credentialing, which means you will be unable to accept insurance from new clients. Accreditation enables therapists and other mental health practitioners to establish their practice or relocate without losing access to insurance panels covering their services. Additionally, it provides you extra leverage when negotiating a better wage with your company, as you are not as reliant on them for insurance billing.
Historically, therapists could rely on their new clients’ PPOs (preferred provider options).They exempted mental health practitioners from the requirement to be on insurance panels or accept HMOs. However, times have changed, and consumers now prefer HMOs to PPOs, becoming increasingly scarce. Even if a prospective customer uses PPO, you will still be subject to penalties and fines if you are not part of their network. PPOs are no longer financially sustainable, but that does not diminish the public’s desire to use their insurance to obtain therapy and other services.
In the United States, the Affordable Healthcare Act has created a new atmosphere where virtually everyone may see a counselor. This is fantastic news for counselor’s in-network with insurance companies, but it is a disadvantage for everyone else who relies on cash-only patients. This is because universal healthcare entitles everyone to insurance coverage for all medical expenses, including mental health. The Mental Health Parity Act had also affected, as it officially specifies mental health coverage as a medical need when it was previously voluntary.
Panels are closing
Additionally, as a result of universal healthcare, other practices compete for the same insurance panels, which mean they are rapidly closing. Insurance companies cannot afford to be in-network with everyone, resulting in a loss of revenue. Obtaining credentialing should be a top concern for therapists and mental health providers who wish to expand their client base to patients whose competition cannot serve. That said, getting on insurance panels requires a significant amount of time and resources, which you may not have available. As a result, our team at House of Outsourcing provides comprehensive credentialing services for physical therapist. We’ve assisted hundreds of clinics across the nation in gaining access to their ideal panels to expand their operations. Whether you’re interested in going it alone or learning more about what our team can do for you, contact us now to evaluate your choices.
What our Provider Enrollment services include:
• An “All Purpose” credentialing manager who will represent you to governmet and private payors
• We submit all applications and associated documents on your behalf to the payor networks and government institutions of your choice
• Status reports keep you informed of your progress with each payor
• We are updating and maintaining the CAQH profile
• Complete all required credentialing criteria for each payor
• Follow-up on all payor contracts until the contract’s effective date and give a copy of the considered complete contracts and fee schedules to your practice or billing business
How long will it take me to complete the application?
The typical TAT for an application is 45-90 days. However, based on our experience, the process typically takes 60 days, depending on a variety of conditions. You are also kept up to date on the status of your application at least twice a month. And we will notify you if there is any unwelcome delay. To summarize, we are attempting to process and finalize your application before or within our 45-90 day TAT standard.
How do I bill the fee negotiation?
Assume you requested five insurance fee negotiations. All five insurance firms will be contacted and negotiations will take place. If you do not receive the application and the insurance is insufficient. We will not charge any fees for this insurance.
What happens to my paperwork when the insurance is submitted?
We always keep your documents secure. We erase all papers from our database once insurance certifies your completion. We’ll let you know about it as well.
How are you maintaining my documents?
Outsourcing House uses an encrypted database storage system. To protect your privacy and confidence, we keep every confidential detail/document of our clients on file for a long time.
How do you handle fee negotiations?
Yes, we can negotiate rates; however this is an extra service we provide. Our department will send you an e-mail with the pricing structure so you can double-check it.
Would you be willing to assist me in obtaining credentials if I have been barred from participating in federal programs?
Yes, we can do it, but you must explain in detail why you were kicked out of the government program.
Is the situation still unresolved?
The insurance company must be notified, and the provider must accept it. We may not be able to assist you in obtaining credentials if you only provide us with partial information. If this occurs only because you did not share the entire report with us, you will be charged for the whole service. We will do our utmost to obtain your credentials if you provide us with complete information.
How long does it take to complete the credentials process?
PPO plan credentials typically 45-90 calendar days to process. Credentials often take 60-90 calendar days to process because to the requisite documentation (particularly in Medicaid plans).
How much time do you spend setting up?
We will want a signed agreement as well as supporting paperwork from you. We will begin submitting applications for you after you have submitted your documentation. If everything goes as planned, it should last about 1-2 days.