Medicare Credentialing: A Comprehensive Guide for Healthcare Providers

Рет қаралды 1,600

Күн бұрын

Пікірлер: 25

@amandamartinez6115 4 ай бұрын

I've learned how to get credentialed with BCBS, Cigna, Aetna, and UHC. However I am learning that Medicare is a beast of its own. Interested in taking a course.

@navigatingthebusinessofmed8251 4 ай бұрын

Hi there! Great job on what you’ve done so far. Medicare is really not that difficult if you know the steps. Unfortunately my course does not go into step-by-step for Medicare. The first step is getting permission in the I&A portal to work on behalf of the group and providers you need to credential/reassign for Medicare. You need to create your own log-in to access I&A. There are instructions on that website that to help you. When completed and you’re a user, you need to make sure they grant you permissions in PECOS specifically when they authorize you under their own accounts. Your credentials work in I&A, NPPES and PECOS (Medicare). Good luck!

@amandamartinez6115 3 ай бұрын

@@navigatingthebusinessofmed8251 Thank you!!

@amandamartinez6115 3 ай бұрын

@@navigatingthebusinessofmed8251 I am thinking about taking the Credentialing Specialist course in AAPC to get the certificate. I still haven't started Medicare yet, its my next project to learn. Thank you for the advice above.

@MarkNath Ай бұрын

Thanks!

@navigatingthebusinessofmed8251 Ай бұрын

Wow, I really appreciate it!

@hasnainraza4881 Жыл бұрын

Very Informative video ❤

@navigatingthebusinessofmed8251 Жыл бұрын

Thank you!

@MarkNath Ай 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 Ай 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.

@user-wo9jj6ii6t Жыл бұрын

Great video Thank You. Do you know if providers need to be assigned to a surgery center if they are doing cases there once a month? Assuming the ASC is Medicare/Medicaid credentialed

@navigatingthebusinessofmed8251 Жыл бұрын

Hi Tim, great question! Yes, in order to bill and be paid as in-network with Medicare, providers need to be assigned to any entities that bill with them as a rendering provider. Thank you for watching!

@DanilaJimenez-z1y 18 күн бұрын

super helpful thank you for the information. I'm an NP currently credentialed with Medicare at a non-profit women's clinic in Texas. I also have a license in New Mexico but we are not credentialed in New Mexico. Do we (practice & myself) have to apply for Medicare for the practice again in NM and then credential me or is there something else we can do since we are already credentialed with Medicare in Texas?

@navigatingthebusinessofmed8251 17 күн бұрын

Good morning and thank you for watching! Providers and groups (both) need to be enrolled with Medicare in each state they wish to practice and serve Medicare beneficiaries. This is the credentialing and contract process for Medicare. It can all be done through PECOS for groups/organizations and individual providers. Good luck!

@DanilaJimenez-z1y 16 күн бұрын

@@navigatingthebusinessofmed8251 thank you so much!

@pattran1282 4 ай бұрын

Thank you for the information. Do you know what is an appropriate physical address to use when I apply for Medicare credentialing since my practice will be mobile service and I am a nurse practitioner in FL?

@navigatingthebusinessofmed8251 4 ай бұрын

Hi and thank you for watching! Since you’re going to be doing mobile service and not have a brick and mortar building to see patients, they will accept your home address. You can also call your Medicare Administrator Contractor (MAC) to ask while completing the application as well. Good luck!

@timjenkins9918 3 ай бұрын

How do I get a community mental health center set up with medicare?

@navigatingthebusinessofmed8251 3 ай бұрын

Hi there- you need to use the PECOS website to get the group enrolled then reassign all providers who will be working there under that group once approved. This is assuming the provider is already credentialed individually with Medicare. I encourage you to watch my videos on PECOS and other KZbin videos on other channels. Good luck!