At 1ˢᵗ Credentialing we know that when our clients place their trust in us, we take that responsibility seriously by communicating with our clients to create a transparent and collaborative partnership.
Healthcare organizations of every size realize that hiring 1ˢᵗ Credentialing is the most economical and efficient way to solve their credentialing needs. We have the training, expertise and commitment it takes to keep a complex process moving forward at all times.
1ˢᵗ Credentialing supports healthcare practices of all sizes - from health systems, to community hospitals, to large group practices, to smaller organizations. We help get your providers up and practicing as fast as possible.
Learning more about the credentialing process benefits us and our clients. 1ˢᵗ Credentialing offers regular videos and newsletter updates to bring our clients and those interested in innovations in credentialing up to speed.
Michigan Medicaid Providers Must Be Screened and Enrolled Effective January 1
Starting January 1, all providers who see Michigan Medicaid beneficiaries must be screened and enrolled in the Michigan Medicaid program.
This requirement includes those providers participating in a Managed Care Organization’s provider network. These must enroll through the Michigan Department of Health and Human Services’ online Medicaid enrollment and billing system known as Community Health Automated Medicaid Processing System (CHAMPS).
The change is part of federal regulations under the Affordable Care Act and is intended to strengthen program integrity by preventing provider fraud. Its intent is to ensure that all providers participating in Medicaid comply with federal screening and enrollment requirements. Regulations prohibit payment to providers who have not been appropriately screened and enrolled.
Compliance Timeline Differs Based on Provider Type
Those providers enrolling in CHAMPS form 2 categories:
Typical providers are professional health care providers that provide health care services to beneficiaries. They must meet education and state licensing requirements. They must also have assigned National Provider Identifiers (NPIs) and include, for example, physicians, physician assistants, dentists and certified nurse practitioners.
Atypical providers provide support services for beneficiaries. They may not have NPIs and generally do not have professional licensing requirements.
The Michigan Department of Health and Human Services will prohibit Managed Care Organizations from making payments to all typical providers not enrolled in CHAMPS beginning March 1, 2018. For service dates on and after May 1, payment for prescription drug claims written by a prescriber who is not enrolled in CHAMPS will be prohibited.
The enrollment of atypical providers will be enforced beginning in fall 2018.
If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.
Our credentialing experts are here to help you assess exactly which solutions you need and let you know how inexpensively we could put you on the right track. 1ˢᵗ Credentialing includes primary source verification and payor enrollment for all insurance networks including Medicare, Medicaid, Medi-Cal and insurance networks. Don’t wait another minute, contact our terrific team today!