Questions About PPO and Medicaid Credentialing

The process of becoming credentialed to receive PPO insurance and Medicaid reimbursements can be a challenging one.

Most practices may not have much spare time to spend filling out a multitude of forms for every insurance company, including Medicaid, or don’t have the resources to do it efficiently. Fortunately, we can help! Today, we make the process a little clearer by answering a few common questions about PPO and Medicaid credentialing.

How do I apply for credentialing?

Every insurance company has its own resource for seeking appropriate credentialing. The Medicare Savings Program (MSP) and Model application can be found by visiting their website here: https://www.ssa.gov/benefits/medicare/prescriptionhelp/cms.html.

How long does the process take?

While credentialing differs between insurance companies and Medicaid, the process typically takes 3-6 months, and includes more than 30 pages of paperwork that can take up to 40 hours or more to completely fill out. However, a team of seasoned professionals can take over the process for you, allowing you to continue focusing on your practice throughout that time. 

How do I negotiate the best fees?

Negotiating the best fees for your practice may be the most challenging part of the credentialing process. If you don’t have enough negotiating power, then consider working a company that has extensive network connections and understands the insurance negotiation process.

How can I get help with the process?

If you’re new to credentialing, or simply want to avoid having to handle the process yourself again, then a group of professionals can help optimize the entire process and results for you. That includes providing regular updates on the progress of each credentialing application.

Learn more by giving us a call

If you have more questions about PPO and Medicaid Credentialing, we can help. To learn more about we can streamline the process by handling it for you, contact PPO Experts today!