2 ай бұрын
2 ай бұрын
Пікірлер
@sharondagordon6206 19 сағат бұрын
What are the steps to take if the payor is unable to pull the providers application from CAQH?
@torrancemercado643 23 сағат бұрын
What is your criteria for persons, (non-clinical) Healthcare professionals, to collaborate with you in a video? I ask because of day to day operations that could help shed light on specific solution sets. From someone charged with responsibilities you discuss. I believe this be a special partnership in interest of all parties. Most of all beneficial to the audience, but still beneficial to your brand..and that of the other healthcare professional.
@sharondagordon6206 Күн бұрын
How and where would determine if a payor is a good option for your practice
@navigatingthebusinessofmed8251 Күн бұрын
Thanks for asking! You could see how popular that insurance is in your area to determine if the potential patient volume with that insurance would be worth the Credentialing and contracting efforts. f you have worked in healthcare for a while or if anybody associated with the practice, has they should be able to tell you that. However, usually a lot of people make a decision at the point of seeing what the reimbursement will be once a contract is sent over because that is a major factor for most. I appreciate you watching!
@mohammadqabir5272 Күн бұрын
Can you please make a video on Medicaid Minnesota provider credentialing ? Thank you.
@navigatingthebusinessofmed8251 Күн бұрын
Thank you for watching. Credentialing and contracting with state Medicaid plans are pretty straightforward and all the information can be found at each states’ Medicaid website. Here is Minnesota’s for your reference www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=ENROLL-HOME I hope this helps!
@deesantiago7092 Күн бұрын
I received denial due to different provider on auth vs different interpreting provider (sleep study). Anyone experience this?
@navigatingthebusinessofmed8251 Күн бұрын
Hi there and thank you for watching my video! Unfortunately, you would have to have an authorization through the insurance company for any provider whom would be billing for services related to that patient. If you had a patient who saw a provider who performed the study and there was a different interpreting provider that was billing separately for that service, then you would need an authorization for both providers. I appreciate your support!
@thefuzzyfrenchie725 3 күн бұрын
It has been a challenge to find a coding job as a newly certified CPC. I was fortunate to come across your informative video, which gave me a bit of insight to Prior Authorizations as an entry level job where I can start to put my skills to work. Very helpful! And you also made me LOL when you said, "Yeah, I'm serious! There's more, just hold on!" LOL, Thank you!
@jeanpaulin398 5 күн бұрын
As a credentialer, these questions are really essential! Really appreciate you putting all the information.
@navigatingthebusinessofmed8251 5 күн бұрын
Thank you for your feedback! I appreciate you watching too. Have a great day!
@patrickdali9124 6 күн бұрын
This is truly amazing work thank you!
@navigatingthebusinessofmed8251 6 күн бұрын
Glad you like it! Thank you for watching!
@codeinception.905 6 күн бұрын
Can we get provider credentialed as on OON with any other state?
@navigatingthebusinessofmed8251 6 күн бұрын
Thank you for watching. You don’t credential and contract providers unless you want to be participating/in network. If you don’t do anything, then they would be out of network. The risk you take is denied for patients who do not have out of network benefits. It would be better, in my opinion, to just charge out of state patients a self-pay, pay at the time of service rate.
@codeinception.905 4 күн бұрын
@@navigatingthebusinessofmed8251 Sure thanks alot for your guide
@codeinception.905 6 күн бұрын
hey i have a quick question, i have provider who is philabotmist and Texas Medicaid, and aetna is not accepting they are keep saying we dont accept this specialty, could you please advise how i can enroll?
@navigatingthebusinessofmed8251 6 күн бұрын
Phlebotomist are not contracted or credentialed. They are a staff for a group and their services are billed under the ordering provider. Phlebotomist are not considered a medical provider, but more like a nurse or medical assistant. You do not get staff credentialed or contracted because they work on behalf of the ordering medical provider. I hope this helps.
@codeinception.905 4 күн бұрын
@@navigatingthebusinessofmed8251 Thank you so much.
@vinodpandith9063 9 күн бұрын
Thank you Jen.
@navigatingthebusinessofmed8251 9 күн бұрын
You're welcome! Thanks for watching.
@MarkNath 10 күн бұрын
Thanks so much for the informative classes. When getting a group contract with Medicare (through PECOS), assuming you are the only provider, do you need to add yourself as a reassigned provider?
@navigatingthebusinessofmed8251 10 күн бұрын
You are very welcome! Thank you for watching. If you’re the owner and listed on the new group at the doctor you are usually reassigned with the new group enrollment as the owner doctor.
@MarkNath 10 күн бұрын
Thanks!
@navigatingthebusinessofmed8251 10 күн бұрын
Wow, I really appreciate it!
@Connectpro-h2u 10 күн бұрын
Your videos too good can i get your linkedln or anything else i have some questions about billing telemedicine maybe your answers will helpful for my business
@navigatingthebusinessofmed8251 10 күн бұрын
Hi there! Please email me at [email protected] and I’ll see how I can help. Thanks for watching!
@Connectpro-h2u 9 күн бұрын
@@navigatingthebusinessofmed8251 I just sent you an email regarding some advice and potential collaboration in the DME field. Looking forward to your response!
@Connectpro-h2u 10 күн бұрын
Hey there I have some questions that can helpfull my business can i get your linkdln or anything plz
@zulmafeliciano9 14 күн бұрын
First, I want to thank you for the very detailed and specific information. Second, I want to know if Medicare Part B pays for the CLIA wave testing with modifier QW? Thank you
@navigatingthebusinessofmed8251 13 күн бұрын
Thank you for watching. I’m glad you’ve found it helpful! Yes they do and they have a separate fee schedule for labs they pay for that you can find on their website. Good luck!
@JBoy340a 14 күн бұрын
Thanks. More of the doctors in my area are going to the Concierge model.
@navigatingthebusinessofmed8251 11 күн бұрын
Wow! That is very interesting. Thank you for sharing and for watching!
@brandyrobbins4456 15 күн бұрын
what if i apply for multiple states for DEA but only have 1 physical address in my primary state? Can I use an out of state address as I do telehealth?
@navigatingthebusinessofmed8251 15 күн бұрын
You would need to look on the DEA website how they handle these situations as I’m not familiar with this specific circumstance. Good luck and thank you for watching.
@zahoorullahminhas8533 16 күн бұрын
Hi Jennifer, I hope you're doing well! I need your advice on a credentialing matter. I have a provider, an MD specializing in Internal Medicine, who is credentialed with UHC and linked to a tax ID. The tax ID is the same for both the group and the individual provider. However, the group application is still in process, and she is the only provider in the group. My questions are: Can she bill UHC since she is linked to the tax ID? Does she need group enrollment, or is individual enrollment sufficient? As always, your guidance on credentialing would mean a lot to me. Thank you! Stay safe and healthy. Best regards, Zahoor
@navigatingthebusinessofmed8251 14 күн бұрын
Hi there- there are 2 questions I have: 1) does she have a contract as a sole proprietor already with UHC and that TIN? If so, then yes she can bill. If there is no contract reflecting her name, NPI1 and TIN with UHC showing an effective date then no. 2) Will UHC allow group contracts for only 1 doctor? Some insurances won’t. If that’s the case, then it would be a sole proprietorship contract you would be waiting on. I hope this helps and thank you so much for the kind words! Good luck!
@zahoorullahminhas8533 14 күн бұрын
@@navigatingthebusinessofmed8251 Thanks, Jennifer! The provider has a contract starting in September 2024, linked to her Tax ID, and I used her NPI 1. I spoke with UHC about group enrollment, and they needed a W-9, which I’ve submitted. The provider is in California. Have a great weekend!
@zahoorullahminhas8533 14 күн бұрын
Thank you, Jennifer. My manager actually advised me not to mark this provider as in-network since the group enrollment is still in progress. I wanted to confirm this with you first. You have a great understanding of credentialing. Stay safe and healthy!
@HeathersCultureCrossings 16 күн бұрын
Thank you so much!
@navigatingthebusinessofmed8251 16 күн бұрын
You are most welcome! Thank you for watching!
@sherrittahughesphdlpc 16 күн бұрын
I paid a credential specialist about $235 after trying do panel myself and getting denied. It is worth it.
@navigatingthebusinessofmed8251 16 күн бұрын
Thank you for sharing your experience. I hope it’s going better for you!
@donfrance3 17 күн бұрын
I am a mountain endurance athlete and my domestic NM wife sent me to lock up medical facility far away using her power of attorney -- and I fought the nurses and doctors daily to remain drug free. they didn't believe me. they offer pills for everything and push hard. Dr.s even say if you don't take the medications I prescribe for you then you are not cooperating and we will just keep you here longer. I was like what/ are you kidding me. I never will take anything and I fought them nightly as they sent in paramedics so there would be more of them to fight, but calmly asserting my rights in front of the cameras worked -- just no sleep and no safety there. does this sound familiar to anyone?
@navigatingthebusinessofmed8251 16 күн бұрын
I am sorry you had to endure that, but thank you for sharing. I have not personally experienced this, but it is very important to remember that patients do have rights. I appreciate your input.
@stupidka9344 19 күн бұрын
Centen Medicaid thru nia is so strict in approving prior auth
@navigatingthebusinessofmed8251 19 күн бұрын
Yes, most Medicaid programs have strict guidelines on what they will and will not cover. Reviewing their online policies and guidelines help reduce unnecessary submissions of prior authorizations. Good luck and thank you for watching!
@zahoorullahminhas8533 21 күн бұрын
Great work
@navigatingthebusinessofmed8251 21 күн бұрын
@@zahoorullahminhas8533 thank you!
@usman_ali23 22 күн бұрын
good 1
@navigatingthebusinessofmed8251 20 күн бұрын
Thanks for watching
@usman_ali23 22 күн бұрын
Could you please create a video on how to use CMS Fee schedule tool 2024
@navigatingthebusinessofmed8251 19 күн бұрын
I already have an older video that reviews this. I will look at possibly doing a newer one soon. Thank you!
@usman_ali23 22 күн бұрын
i have observed , you are catering v imp topics related to RCM, thumbs up to you and thank you so much.
@navigatingthebusinessofmed8251 20 күн бұрын
Your welcome
@feliciakelly-brookins6899 23 күн бұрын
The volume on the video is too low. The presenter needs to speak louder or closer to her mic.
@navigatingthebusinessofmed8251 20 күн бұрын
I have listened to many parts of the video and have no problem hearing the video, although it is definitely an old video, the sound quality is likely not as good as my newer videos. Will definitely consider doing an updated version. Thanks for watching!
@bertan8510 24 күн бұрын
I like your cup. My nice played softball for Univ of O
@navigatingthebusinessofmed8251 24 күн бұрын
@@bertan8510 thanks! That is so awesome! I’m a HUGE Ducks fan!! I’m so ready for this weekend to kick off our first football season in the Big 10. I appreciate you watching my videos. GO DUCKS!!
@bertan8510 25 күн бұрын
Thanks for what you do. I am glad I found your channel. Just to let you know, as a doc and I think a lot of docs feel this way; we think the insurance companies make it so difficult for us to do our jobs and get paid appropriately.
@navigatingthebusinessofmed8251 24 күн бұрын
You are so welcome and I’m glad you found me as well! I couldn’t agree with you more! I understand. There is so much worry and awareness around provider burn out right now but no one wants to talk about the elephant in the room of insurances making things more difficult all the time and the growing compliance and regulations in healthcare. I appreciate your support and for commenting!
@InaJackson-zm3fb 25 күн бұрын
Davis Robert Rodriguez Maria Jackson Angela
@navigatingthebusinessofmed8251 25 күн бұрын
Thanks for watching
@felisak6053 26 күн бұрын
Do you offer 1 on 1 coaching? Btw, I enjoyed your video always.
@navigatingthebusinessofmed8251 24 күн бұрын
Yes, I do. I responded to your email as well with more details.
@achiveatthe1percent 26 күн бұрын
Hi, I need to discuss a case We have a multi location practice, we have MD how is the partner in the business and the group have a group txt ID and NPI under his name and all the other providers are enrolled under the group and now we are planning to send claims to the insurance, Do the owner provider has to sign all the encounters or any of the rendering provider can also do that!
@navigatingthebusinessofmed8251 24 күн бұрын
Hi and thank you for watching my videos! It depends on multiple factors. The biggest one is if you have an MD who is listed as the mid-levels (PAs and NPs if you have them) supervising doctor at their boards and what the state’s requirements are for them. It also can be depending on your supervising agreement with the mid-levels and the doctors internally. The insurances in your area may have their own guidelines for this too. You would need to check with each. As far as for billing, if all are individually credentialed and enrolled under the group contract as individuals then you can bill under them and they can sign their own notes for claims purposes. Good luck!
@merarirodriguez2127 27 күн бұрын
Does your credentialing training consist of "What our fees to physicians?" And does it prep us to take to national test?
@navigatingthebusinessofmed8251 26 күн бұрын
Hi there! The course does not review how to set up fee schedules. Although it does require reviewing contracts with the payers, it is a little separate and usually credentialing specialist. Don’t do this for their clients. In order to figure out the fees, a practice would need to look at all of their payer contracts to see who would be the highest reimbursement and then decide from there. I have a video that goes over this process for you. In regard to your second question, I am not sure if my course covers all of the information that you would be tested on to get certified. I have never taken the test myself so I am not sure what those questions consist of what knowledge they expect you to have. I designed this course to help people decide if they want to pursue a future in credentialing and contracting and also for the person kind of being thrown into these roles and responsibilities who need guidance. I hope this helps. I appreciate your support!
@felisak6053 26 күн бұрын
Hi Jennifer, i purchased your beginner course and will get the intermediate and 3rd course as well. I sent you a message through my portal. If you know someone that is looking for part time credentialing let me know I am looking for.
@merarirodriguez2127 26 күн бұрын
@navigatingthebusinessofmed8251 Wonderful! It does, tha k you. However, the type of fees I was referring to was how much to charge a physician if I were to set up my own Med/Credentialing business to offer these services to medical practices. I guess kind if what you do. I am looking to know how to approach these practices to gain the business. Is that something you teach or have videos on? Helping other Credentialing Specialists to become equipped enough to possibly do this type of business? I guess was my question. Tha k you again for your amazing videos!
@ambermcmanus6336 28 күн бұрын
Hi, I'm very interested in signing up for your courses. I have been in in healthcare for 17 years.. do you feel your courses will be helpful to pass a certification test?
@navigatingthebusinessofmed8251 26 күн бұрын
Hi there and thank you so much! Unfortunately, I’m not sure the exact content of the certification test as I have not taken it myself to know what is needed to pass. I can tell you I created this course for people like me who where thrown into this responsibility in a practice and had to learn as I go. It’s the information that should help provide a foundation of building from in this realm of healthcare. Good luck!
@zahoorullahminhas8533 28 күн бұрын
Dear Jennifer, I hope this comment finds you well. I wanted to take a moment to express my gratitude for the knowledge I’ve gained from your videos on credentialing. Your insights have been incredibly valuable, and I appreciate all the effort you put into sharing this information. Currently, I am working with a Nurse Practitioner ( DNP, PMHNP Title: PMHNP) specializing in Psych/Mental Health, and I need to enroll her with MaineCare (Medicaid ME) and Optum. She requires both individual and group contracts. Could you please advise whether it is necessary to credential her with Medicaid ME before proceeding with her credentialing with Optum? Thank you in advance for your assistance. Best regards, Zahoor Minhas
@navigatingthebusinessofmed8251 28 күн бұрын
@@zahoorullahminhas8533 hi there and thank you for your kind words. I’m so happy to hear my videos have been helpful to you. I would recommend initiating credentialing with the payers ASAP while simultaneously asking for an enrollment contract. You can always let the other insurances know the Medicaid credentialing is in process. Some may require it to be completed before they move forward with their application for their Medicaid lines of service, but at least it would be on its way to completion when that happens. Good luck and I appreciate the support!
@zahoorullahminhas8533 28 күн бұрын
@@navigatingthebusinessofmed8251 Thank you so much.
@zahoorullahminhas8533 28 күн бұрын
Thank you for sharing this. Best Regards
@navigatingthebusinessofmed8251 28 күн бұрын
Thanks for visiting
@felisak6053 29 күн бұрын
This is amazing video as a reference. Thank you so much! I have a question if I am working on behalf of the new clinic and I wanted to create/apply their NPI 2 do I need to access in my own NPPES profile? Or do I need to add that employer in my own I&A first before proceeding to NPPES? Your insight is greatly appreciated, thank you.
@navigatingthebusinessofmed8251 28 күн бұрын
Yes, you usually can request an NPI 2 on behalf of a group. It gives that option when you log-in to NPPES. If everything is completed successfully then the NPI could be assigned almost simultaneously. However, it is easier to work on behalf of the group for other needs too by just getting approval by the owner to have it assigned under your account. Thank you for watch and the kind words. I’m happy to hear my videos have been helpful. I appreciate the support.
@zahoorullahminhas8533 29 күн бұрын
How to enroll provider and group with MaineCare (Medicaid ME)
@navigatingthebusinessofmed8251 28 күн бұрын
You need to go to the Maine Medicaid website for provider enrollment and follow their instructions.
@mohammadqabir5272 Ай бұрын
Can you suggest me any CCM software budget friendly?
@navigatingthebusinessofmed8251 Ай бұрын
@@mohammadqabir5272 hi there and thank you for watching. I apologize but I’m not aware of any CCM-only/specific software. Although I know expense is a factor and could be an ultimate reason someone may choose one software over another, please keep in mind that you get what you pay for. If it sounds inexpensive, often it’s more of an a la cart system that ends up charging for separate features and may end up costing more in the long run than if you went with a software that is more expensive but all encompassing. Good luck!
@beautyandyou8873 2 күн бұрын
Yes i have software
@OldBlindMan73 Ай бұрын
Thank you for this information.
@navigatingthebusinessofmed8251 Ай бұрын
Glad it was helpful!
@zaidisahabg Ай бұрын
Medical insurance data needed!
@navigatingthebusinessofmed8251 Ай бұрын
I would like to try and help further, but I would need to know exactly what you are requesting. Thank you.
@Omar123ABC Ай бұрын
Great video. Thanks
@navigatingthebusinessofmed8251 Ай бұрын
I’m glad you found it helpful! I appreciate you watching!
@zahoorullahminhas8533 Ай бұрын
I’ve greatly benefited from your videos-they’ve been incredibly helpful to me. I would like to request videos on credentialing providers and groups across all states, covering major payers. Ideally, a guide for all 50 states would be invaluable. Thank you for your continued excellence, and I hope you have a wonderful weekend. Stay blessed!
@navigatingthebusinessofmed8251 Ай бұрын
Thank you for your support and kind words. I’m happy to hear they have been beneficial! I will see what I can do with the request.
@athomewithsareeta Ай бұрын
Would it be a good idea to email a physician office offering my virtual assisting services? ... I specialize in insurance verification and prior authorization
@navigatingthebusinessofmed8251 Ай бұрын
Hi there and thanks for asking. To get your name out there and build your client list that is not a bad idea, although I feel in-person advertising may be a good initial approach. Good luck!
@athomewithsareeta Ай бұрын
@@navigatingthebusinessofmed8251 thank you for the tip ... I wanted to do it in person originally so I'll do both... Thank you so much for your content ❤️🔥🫶🏾❤️🔥 I love how you deliver your experience and knowledge!
@Syedaliraza7214 Ай бұрын
Thank you so much for sharing the details and thank you for sharing the guide. It was just the thing i was looking for 👍
@navigatingthebusinessofmed8251 Ай бұрын
Glad you found the video helpful!
@Syedaliraza7214 Ай бұрын
Thank you so much it's really helpful for me 🙏
@navigatingthebusinessofmed8251 Ай бұрын
Thanks for watching!
@mohammadqabir5272 Ай бұрын
Very informative. I heard there is a website or application where we can find the current reimbursement per CPT code from insurance companies, and this can be looked up by NPI. Im not talking about the fee schedule.
@navigatingthebusinessofmed8251 Ай бұрын
Hi there and thank you for watching. If there is something like this then I would love to know about it! I only know about the Medicare Physician Fee Schedule and Medicaid state fee schedules that are available to the public. I don’t even know any insurances that you can log-in to their portal to see your individual agreed upon fee schedule so please let me know if/when you find this!
@Boog-Burley Ай бұрын
Hi I’m interested in your course(s). My sister is an LCSW that operates a practice employing a few dozen clinicians. I just started helping her and she needs a new credentialer. The issue is she is terrible at teaching/explaining things and also doesn’t have the time to really teach me, are your courses specific towards behavioral health insurance credentialing, or is credentialing universal in healthcare?
@navigatingthebusinessofmed8251 Ай бұрын
Hi there! Thank you for watching and for asking the question. All credentialing is done exactly the same and you just provide the specialty of behavioral health when you’re working on it with payers. They will also know by the use of taxonomy codes associated to the providers’ and group NPI numbers. My course is for general credentialing and contracting so It should help you. I also can be hired to coach you along the way and teach you what you need to do. If you are interested, you can email me directly [email protected].
@MuhammadHamza-b5o Ай бұрын
Hey Jennifer Let Me Know If We Recieve An Order From The Pt Doctors Office For The Brace So Does A Normal Person Can Bill From Medicare ?
@navigatingthebusinessofmed8251 Ай бұрын
@@MuhammadHamza-b5o Here is a great resource for you regarding billing DME at Medicare under Part B coverage. www.medicare.gov/coverage/durable-medical-equipment-dme-coverage Good luck and thank you for watching!
@MuhammadHamza-b5o Ай бұрын
@@navigatingthebusinessofmed8251 Thanks For Letting Me Know But My Question Is Like A Normal Person Can Bill Medicare ?
@navigatingthebusinessofmed8251 Ай бұрын
@@MuhammadHamza-b5o I’m sorry I don’t understand what you mean by “normal person.” Only doctor offices and healthcare providers credentialed and enrolled with Medicare can bill Medicare directly. Non-healthcare professionals cannot. I hope this helps.