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.
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
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 provide you with a comprehensive checklist detailing all the necessary documents and information required to successfully file your Medicaid provider application.
Annual Credentialing Maintenance
We have the capability to deliver essential and precise management services for healthcare facilities of a larger scale, particularly those that accommodate multiple providers.
Application Follow Up
Our dedicated team will diligently follow up on your submitted application within a period of two weeks to ensure and confirm that it has been successfully received.
Appeals for Closed Panels
There are instances when payers have closed panels, and in such cases, we will take the necessary steps to submit a formal appeal on your behalf.
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 secure contracts for you, but we also take care of the entire negotiation process to ensure favorable fee rates.
Demographic Changes
We are also equipped to assist you with essential demographic changes, including updating a new address, modifying bank account details, or revising your TAX ID with each of the payers included in your payer mix, ensuring seamless transitions and accurate records.
Network Research
We take proactive measures to ensure that your group or practice is aligned with the most effective, diverse, and widely recognized mix of in-network payers, optimizing your reimbursement opportunities and overall financial stability.
Out of Network Enrollments
This specialized service is designed for providers who choose to stay out of network or are required to do so due to restrictions imposed by specific payers, ensuring they can still navigate their reimbursement options effectively.
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
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:
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
If applicable, you may need to choose a specialty designation. For example, if you are a psychologist, you will need to select either the independently practicing psychologist designation or the clinical psychologist designation.
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 requested supporting documents, including your medical insurance certificate, medical licenses, diploma copies, 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 clear and fixed price for every application, guaranteeing complete transparency with no hidden costs.
Full assistance
We provide comprehensive assistance to your billing team, ensuring smooth operations and accurate processing.
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 collaborate with our dedicated and knowledgeable staff, who have extensive experience in Medicaid and Medicare enrollments, ensuring a smooth and efficient application process.
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:
Hospitals
Ambulatory Surgical Centers
Medical Laboratories
Physician group practices
Skilled Nursing Facilities
Teleradiology and telehealth
Ambulatory Surgical Centers
Hospitals
Ambulatory Surgical Centers
Medical Laboratories
Physician group practices
Skilled Nursing Facilities
Teleradiology and telehealth
Hospitals
Ambulatory surgical centers
At Bikham Healthcare, we also enroll the following specialties:
OBGYN
Durable Medical Equipment
Cardiology
Radiology
Orthopedic
Laboratory
Behavioral Health
Sleep Medicine
Anesthesiology
Urology
Chiropractic
Surgery
Internal Medicine
Physical Therapy
Obstetrics & Gynecology
Rehab Billing
In our 18 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
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.
