1. Do I need my malpractice insurance set up before starting my new practice?

   • Yes, we cannot start any credentialing until you have a face sheet from your insurance company. The face sheet needs to list the name of the practice you will be working with moving forward. If you start a new practice, it will need to list your new practice’s name.

2. Do I need my NPI type 1 and type 2 before I start my new practice?

   • Yes, the Type II NPI number is required by Medicare and helps to identify the entity from the provider. Commercial insurances do not require the use of a Type II NPI but they encourage it, and it keeps your billing processes consistent. The Type II NPI should be reported to all the insurance contracts at your practice.

3. Does CAQH need updated prior to starting my new project?

   • Yes, when doing applications, we need to be sure the information we are providing on the applications matches CAQH or the applications are rejected. Because of this, we need to be sure that all of your information is up to date and accurate.

4. Can you set up my CAQH account for me?

   • We can assist you while creating it, however we typically like our clients to create this account themselves and then we can manage it for you (if you choose the maintenance plan). It is best to create and update the account initially so that we have all the information we need to fill out your insurance applications.

5. Do you need all my logins prior to starting my new project?

   • Yes, We need your CAQH login to complete the applications and verify all of your data is correct. We may need access to other portals such as PECOS and Availity, but we will ask you to add your Coordinator to the approved list within that particular portal.

6. Can I use my home address or cell phone for my new practice until I get a physical address and telephone number?

   • No, you should not use your home address or cell phone. The address and telephone number that is submitted to the insurance company will be listed on the online provider directory and you do not want to list your personal info for your patients. Also, the address/phone number cannot be changed until the application is finalized.

7. Can I use my social security number for my tax ID number?

   • Yes, but you will have to give your social security number to the insurance companies, file it on your claims to get paid and overall expose yourself to identity theft. A tax ID number will protect your personal information and everything will be filed under the company name instead of with your personal data.

8. Do I need a bank account set up in my name or the business name?

   • Must be in the business name for Medicare or a bank letter will be required to identify the account as your business account.

9. Do I need liability insurance?

   • Yes. If you see patients in an office location (brick and mortar), then you will need to prove that you have liability insurance in place with each insurance company.

10. How do I know which insurances to start with at my new practice? Can you send me a list of insurances to apply to?

    • We are unable to keep up with the different geographical areas of each insurance company so drilling down to a specific zip code or specialty is very difficult.
    • You can go to your competitor’s websites in your area to find which insurances they are seeing. Once we have the list from you, we can check with the insurance carrier if they will extend a contract to you or your business.
    • You can also get a list of insurances if you have providers who are referring patients to you. This will ensure you are able to take any referrals from that office.

11. How long does it take to get credentialed?

    • 120-150 days for commercial carriers
    • 90 days for Medicare

12. Who needs to be credentialed in a practice?

    • Any provider who sees patients, i.e., MD, DO, NP, PA, etc.

To learn more about 1st Credentialing and the services we provide, please visit us at 1stCredentialing.com

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