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Medicaid Insurance Credentialing


Medicaid Insurance Credentialing


For many providers, a common hurdle is getting paid for medical services rendered by becoming credentialed with insurance carriers. A range of private and public healthcare professionals provide Medicaid services. The federal and the state governments partner through Medicaid to share the costs of the program. 


Becoming credentialed can be a lengthy process for many healthcare providers and may come as quite a surprise to new physicians. This is why it is crucial to work with a trusted partner like Bikham Healthcare to make the process of completing a Medicaid credentialing application a faster, simpler process. 


What Is Medicaid Provider Enrollment and Insurance Credentialing?


If you want to participate in Medicaid to treat insured patients while also receiving in-network reimbursement, you need to complete a Medicaid credentialing process. This process is known as provider enrollment. During this process, you may need to start with a phone call and complete standard forms. Through the Council for Affordable Quality Healthcare (CAQH), some standardization has been introduced to the process. However, you will still need manual intervention and follow-ups during the provider enrollment process to make sure the process is completed correctly and in a timely manner. 


At Bikham Healthcare, we have developed a process for Medicaid provider enrollment that allows our clients to complete one credentialing process to participate with Medicaid. Your needed credentialing information will be prepared automatically and submitted to Medicaid. With us, you can enjoy a better turnaround time and have access to the highest quality technology during your Medicare provider enrollment and insurance credentialing process.


Bikham Healthcare's Medicaid Credentialing Services


Bikham Healthcare's Medicaid Credentialing Services


Insurance credentialing is the process of applying for inclusion in the provider panels of health insurance networks. At Bikham Healthcare, we specialize in Medicaid credentialing services. After we help you get credentialed with Medicaid, you will be able to bill Medicaid directly. 


The services at Bikham Healthcare for Medicaid credentialing include the following:


  • Application filing: We will send you a checklist of all the documents and information you need to file a Medicaid provider application.
  • Annual credentialing maintenance: We can provide crucial, accurate management of providers for bigger healthcare facilities that have multiple providers. 
  • Application follow up: Our team will follow up on your submitted application within two weeks to confirm that your application has been received. 
  • Appeals for closed panels: Sometimes payers have closed panels, and we will make sure to submit an appeal. 
  • CAQH and PECOS set up and maintenance: In today's healthcare environment, providers need to stay up to date on CAQH and PECOS profiles. We can maintain your profiles and ensure all your information is compliant.
  • Contract negotiations: Not only do we get you contracts, but we also handle negotiations for fee rates.
  • Demographic changes: We can also help you with demographic changes like updating a new address, bank account or TAX ID with each of the payers in your payer mix. 
  • Network research: We ensure your group or practice has the most effective, varied and popular mix of in-network payers. 
  • Out of network enrollments: This service is intended for providers who opt to remain out of network or are forced to remain out of network with specific payers. 

  • If you would like to access these Medicaid credentialing services, reach out to us at Bikham Healthcare.


    How to Enroll in Medicaid as a Provider


    How to Enroll in Medicaid as a Provider


    If you want to know how to get credentialed with Medicaid as a new provider, Bikham Healthcare can help you through the process. Below are the steps to follow if you want Medicaid credentialing status:


    1. Obtain the National Provider Identifier Number


    Your first step is to obtain your National Provider Identifier number, also known as an NPI number. You can obtain one of two types of NPI numbers. Type 1 is an Individual number and Type 2 is an Organizational number. You should get an Individual NPI number before you are hired to practice or before you incorporate your own healthcare practice. You will be able to use this number throughout your career as a medical professional, regardless of where you choose to work. 


    2. Establish Your Billing Structure


    You are likely to work either for a corporation or for your own practice. As such, you should know exactly how you will be billing for your services. Clarify this structure with your employer or with your lawyer and accountant if you own your practice. You should determine this billing structure before Medicaid credentialing because any changes to your billing structure or tax ID number will force you to get credentialed again and start the process over. 


    3. Purchase Medical Malpractice Insurance


    Unless you already have medical malpractice insurance, your next step is to purchase a policy. To get credentialed with Medicaid, you should obtain medical malpractice insurance coverage. You may also be asked for a copy of the declaration page for your medical malpractice insurance. Your coverage limits should meet or exceed the listed amount in the contract with Medicaid. To prepare for the application process, you should have a copy of your declaration page.


    4. Complete Your CAQH Application


    The next step to enrolling in Medicaid as a provider is completing the CAQH application. To save time, you can upload and complete your paperwork online. Even with the convenience of an online application, the process of gathering all the necessary information can be lengthy. Complete your CAQH application before moving on to the following step. 


    5. Contact All the Insurance Providers You Want to Work With


    After completing your CAQH application, get in contact with all the insurance providers you wish to be in-network with. Review the fee schedule and the contract provided by every insurance company before you agree to be an in-network provider.


    6. Get Registered With Medicare


    The final step in the process of Medicaid credentialing for providers is getting registered with Medicare. Medicare beneficiaries include younger disabled people and seniors. If you intend to treat any of these Medicare beneficiaries, you should register beforehand with Medicare. Get registered with Medicare by completing the online enrollment forms


    Medicaid Application Process to Become a Provider


    Follow the steps below in the Medicaid provider enrollment application process: 


  • Gather documentation: A Medicaid agency will want a lot of information from you, including copies of your resumes and licenses and proof of your medical malpractice insurance. Make sure you collect all the needed documentation. 
  • Create a list of questions for the agency: The amount a Medicaid agency will pay providers varies from agency to agency. How quickly you will be reimbursed and the number of hoops you will need to jump through to get reimbursed will also vary by agency, so be sure to create a list of questions you need to be answered. 
  • Get in touch with provider relations: Contact every Medicaid agency to speak with someone in Provider Relations. This person will speak honestly with you about the application process. You can then request an application and ask about the agency's unique clinical needs. 
  • Establish a paper trail: Communicating in writing is important for confirming contractual expectations and details. Though you may want to communicate via phone or in-person to foster relationships, you should follow up on these important conversations through email. 
  • Complete the CAQH application: Most Medicaid Programs require that you complete an application of 20 pages to 30 pages. Unsurprisingly, this can be a lengthy process. Fortunately, the annual updates tend to be fast and simple. 
  • Make copies of everything included in your application: Applications and the support documentation for these applications can be misplaced or lost. Because of this, you may want to make copies of everything included in your application and keep notes about how, when and who you communicated with in Provider Relations, along with what was said. 
  • Submit your application on time: You should complete and submit your Medicaid application in a timely manner. Applications can be rejected if they time out, so stay organized to make sure you submit your application in a reasonable time frame. 
  • Follow up on your application: After submitting your Medicaid application, you should follow up with Provider Relations to ask about how long it will take to process your application. 

  • Hurdles of Getting Credentialing With Medicaid


    Hurdles of Getting Credentialing With Medicaid


    For about half of health center patients, Medicaid is the primary coverage source, which is why it is so important for medical professionals to be able to get credentialing with Medicaid. Unfortunately, providers can face several hurdles when trying to get credentialed with Medicaid.


    One of the most frequently asked questions from healthcare practitioners is how long it will take to get credentialing with Medicaid. In processing Medicaid credentialing applications, the leading causes for delays are inaccurate or incomplete information and missing signatures. When an application does not have errors and is processed on the first submission, the application process will be faster as you will not need to take more time to fix errors or provide additional information. 


    To ensure you complete the Medicaid credentialing application accurately, follow these tips:


  • Ensure you are using the most recent version of the Medicaid forms.
  • Completely fill out every page of the Medicaid application.
  • Sign and date every required place on your application. 
  • Report every malpractice insurance sanction and claim.
  • Attach all the supporting documents that the carrier requests, such as your medical insurance certificate, medical licenses and copies of your diploma and board certification.
  • Plan ahead so you can complete your application in a timely manner. 
  • Partner with Bikham Healthcare for help with the provider enrollment process.

  • Medicaid is a complex program that depends on a partnership between the federal and state governments. Since Medicaid comprises a significant amount of federal and state budgets, the dynamics in this program are crucial. Medical professionals should keep in mind that Medicaid exists to provide health coverage for the nation's most vulnerable families and children when considering the hurdles facing enrollees.


    Benefits of Bikham Healthcare Helping You With Medicaid Credentialing and Enrollment


    Why should you choose Bikham Healthcare to help you with Medicaid credentialing and enrollment? The following are the benefits of working with us at Bikham Healthcare:


  • Faster completion of your application: With our quick turnaround time, we can ensure your application is completed twice as fast as an in-house team. 
  • Fixed price: We offer a fixed price for every application with no hidden costs.
  • Full assistance: We provide complete assistance to your billing team. 
  • Real-time application status: Find out about the status of your application in real time.
  • Account manager: We provide a dedicated account manager who will handle your account.
  • Document alerts: If you have an expiring document, you will receive a real-time alert. 
  • Higher first-time application approval rate: If this is your first time completing an application for Medicaid credentialing and enrollment, we can offer a higher approval rate than our competitors.
  • Experienced staff: You will partner with our staff, who are highly experienced in Medicaid and Medicare enrollments. 
  • Focus on your work: When you allow us to handle the paperwork for Medicaid credentialing and enrollment, you can spend your time focusing on patient care and important tasks needed to maintain your medical practice.

  • Who Can Bikham Healthcare Help With Medicaid Credentialing?


     We serve the following industry segments:


  • Ambulatory surgical centers
  • Chiropractors
  • Durable medical equipment providers
  • Home health agencies
  • Hospitals
  • Medical laboratories
  • Physician group practices
  • Skilled nursing facilities
  • Telehealth and teleradiology 

  • At Bikham Healthcare, we also enroll the following specialties:


  • Anesthesiology 
  • Behavioral health 
  • Cardiology
  • Chiropractic
  • Durable medical equipment
  • Internal medicine
  • Laboratory
  • OBGYN
  • Orthopedic
  • Physical therapy
  • Rehab billing
  • Radiology
  • Sleep medicine
  • Surgery
  • Urology

  • In our 15 years of provider credentialing and enrollment services, we have successfully filed more than 232,000 applications. We can help providers in any state, as we have extensive experience in each of the 50 states and can ensure compliance. 


    Contact Bikham Healthcare for Medicaid Insurance Credentialing and Enrollment


    Contact Bikham Healthcare for Medicaid Insurance Credentialing and Enrollment


    At Bikham Healthcare, we help healthcare professionals get connected and credentialed with Medicaid. Whether you have an existing practice or you are just starting up, we help physicians, healthcare practitioners, hospitals, chiropractors, dentists and physical therapists who need to bill Medicaid as an insurance company and in-network provider. 


    When you choose to work with us, we can get you enrolled with a large number of popular payers, helping you maximize your patient outreach. Providers can avoid the complexities of the enrollment process, which includes extensive documentation and timely follow-ups. Additionally, we will handle all pre-filing credentialing requirements. 


    Contact us at Bikham Healthcare for Medicaid insurance credentialing and enrollment today.