Payor Enrollment Mistake #9: Make Sure You Have the Correct Form for Your Provider Type

It may sound like a simple task and an easy mistake to avoid; but many medical practices consistently select the incorrect forms when completing their payor enrollment process.

The mistake is actually a very easy mistake to make because many of the forms are for specific specialties or provider types. The primary issue that results from selecting or submitting an incorrect form is your enrollment request will most likely be rejected and you will have to start the process over again, costing you months of revenue loss.

So, how do you ensure you have the correct payor enrollment form for your practice or provider?

Understanding your specialty, the providers license details and knowing the nuances of the business you are credentialing is critical. For instance, if you have a FQHC or a Critical Access Hospital, then different applications may be needed for MD’s to be credentialed with the plans than their typical provider application.

Although CAQH provides excellent guidance to collect provider information, the ProView system does not help address the proper forms needed from various insurance companies.

Online resources can be very limited and are typically on the insurance websites when you request to “join a network”. The information for your provider or specialty may not be listed, so a call to the carrier’s provider enrollment department would be best.

If you are not getting the answers you need or are unsure if the information you have is correct, then reaching out for help should be your next step. Enlisting the support of a third-party credentialing service will help reduce lead times and help you reduce mistakes so that your application processes appropriately.

When it comes to selecting the proper forms to use, it is best not to guess and to seek assistance.

At 1st Assistant, we strive to make the Payor Enrollment process as simple and easy as possible for our clients. To learn more about 1st Assistant, please visit our website or join our Facebook Group. Credentialing Talk, where we discuss all the latest credentialing trends and news.