Re: Getting Insurance Credentials

April 5, 2011

Hi ,

Welcome to IMP-dom. I would not recommend hiring a practice managment consultant to do the forms for you. We hired one who came highly recommended and all he managed to do in 2 months time was get the applications for us, when we thought he had already submitted them for credentialing. so we were 2 months behind in our credentialing from the get-go. I'd suggest that you do them yourself. Most insurance companies won't negotiate fees for a new practice, but you could suggest that you already know what they are paying you at your current practice and ask for at least the fees that they are paying you there. Theoretically, you aren't changing the way you practice, just where you practice, so they should pay you the same!

Depending on where you are located, your state or local medical association may have some sort of tool kit to help you wade through the credentialing process. I have a great wealth of information from the CMA, but we haven't had time or energy to renegotiate our contracts. As our practice fills up ( we define our " full " practice as one that has 2 or less empty slots every day for a month and when new patients cannot get into the office within 2 weeks, barring physician vacation or time away from the office), we will be reviewing them to see which ones we can get away with dropping. We hope that will be sometime this year or next. Before that happens, though, Steve is still working a second job and we would have him drop that second job to open up more time for patients.

Good luck,

Pratt

San Ramon, CA

Hello, everyone. I have been lurking for a few weeks and am finally ready start moving forward. I am considering leaving my current practice where I am an employed doc and have decided not to buy-in. I really like the idea of IMP and feel that it would be a great fit for the type of practice I envision. I am looking for a little guidance on the things that seem daunting to me...

Credentialling - it took about two months to get credentials done a few years ago when I started (established practice new provider), I'm not sure if that is a reasonable time line with a new practice if I am already a known entity to the insurers (I would hope to have similar panel to what I have now). I know that it is a boat load of paper work to do, and I have the off time to get this done. However, is there any benefit in hiring a practice consultant (haven't gotten firm estimate, but in the $2K range) just to complete this process and helping wade through the contracts with the insurers (they really aren't up on low overhead practices so wouldn't have them do any more than that). I know to look for language that indicates they can more or less lease you to other networks/insurers. Did any of you hire a lawyers to go through these contracts or just try to understand them to the best of your ability? I've heard there really is no negotiating reimbursement levels when you first apply, you just get what is customary for the area and have to negotiate once your established for a year, is this true?

Everybody seems very helpful and I would love to hear the good and bad of the process to help me decide. I'm running my numbers and getting a spreadsheet and basic business plan together, so still in the starting stages. I hope these aren't too basic questions, I've combed through all the IMP stuff on the website and this was the one place that still seemed like a big black box.

Thanks,

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

April 5, 2011

Dear .

I am in the same boat, trying to open my IMP.

I am done with my bussiness plan. I will create a corporation and I was thinking about getting a practice management consultan for the credentialing.

I know there is a a place that you can process a lot of the plans, I think is : CAQH, I am not sure.

I am thing to get a part time job to suplement my income while I am jumping in my IMP dream.

I do not have all the time to do the credentialing,also you have to do some manuals OSHA etch.

I have been looking around in my town for a office space. I can tell you that in Clermont Florida there are a lot of empty office space.

When I contact the landlords or realtors they want to make me belive that there is a like of potential tenants.

I saw an office empty for almost 2 years and the realtor was trying to be cocky with me, but I know better.

I will try to get some exam tables in ebay( i havent figured out ebay yet).

you are not alone in this journey.

Adolfo

To: practiceimprovement1 Sent: Tue, April 5, 2011 4:00:33 PMSubject: Getting Insurance Credentials

Hello, everyone. I have been lurking for a few weeks and am finally ready start moving forward. I am considering leaving my current practice where I am an employed doc and have decided not to buy-in. I really like the idea of IMP and feel that it would be a great fit for the type of practice I envision. I am looking for a little guidance on the things that seem daunting to me...

Credentialling - it took about two months to get credentials done a few years ago when I started (established practice new provider), I'm not sure if that is a reasonable time line with a new practice if I am already a known entity to the insurers (I would hope to have similar panel to what I have now). I know that it is a boat load of paper work to do, and I have the off time to get this done. However, is there any benefit in hiring a practice consultant (haven't gotten firm estimate, but in the $2K range) just to complete this process and helping wade through the contracts with the insurers (they really aren't up on low overhead practices so wouldn't have them do any more than that). I know to look for language that indicates they can more or less lease you to other networks/insurers. Did any of you hire a lawyers to go through these contracts or just try to understand them to the best of your ability? I've heard

there really is no negotiating reimbursement levels when you first apply, you just get what is customary for the area and have to negotiate once your established for a year, is this true?

Everybody seems very helpful and I would love to hear the good and bad of the process to help me decide. I'm running my numbers and getting a spreadsheet and basic business plan together, so still in the starting stages. I hope these aren't too basic questions, I've combed through all the IMP stuff on the website and this was the one place that still seemed like a big black box.

Thanks,

April 5, 2011

Hi ,

I too just started a solo practice, in Northern California this month! You raised the same questions regarding insurance reimburse rate I've been puzzled in the last a few weeks. I still hold on the PPO contracts with me even though I know I would be the net-work provider. I didn't want to settle with a low new provider rate since I have been practicing in a nearby clinic for years as an employed physician. I hope other members can give me some ideas as well. Is it negociable for solo provider with insurances.

Regarding credentialing, I believe it is much easier than a few years ago with the CAQH system. You may have an account with them already since the common insurances require providers to enter info like DEA, Licence, malpractice insurance, NPI through CAQH. Your current clini may have that infomation.

I just joined this group recently and really appreciate other members' contribution to the forum. I learned a lot everyday here and felt there is a support group.

Wen Liang

San Mateo, CA

Hello, everyone. I have been lurking for a few weeks and am finally ready start moving forward. I am considering leaving my current practice where I am an employed doc and have decided not to buy-in. I really like the idea of IMP and feel that it would be a great fit for the type of practice I envision. I am looking for a little guidance on the things that seem daunting to me...

Credentialling - it took about two months to get credentials done a few years ago when I started (established practice new provider), I'm not sure if that is a reasonable time line with a new practice if I am already a known entity to the insurers (I would hope to have similar panel to what I have now). I know that it is a boat load of paper work to do, and I have the off time to get this done. However, is there any benefit in hiring a practice consultant (haven't gotten firm estimate, but in the $2K range) just to complete this process and helping wade through the contracts with the insurers (they really aren't up on low overhead practices so wouldn't have them do any more than that). I know to look for language that indicates they can more or less lease you to other networks/insurers. Did any of you hire a lawyers to go through these contracts or just try to understand them to the best of your ability? I've heard there really is no negotiating reimbursement levels when you first apply, you just get what is customary for the area and have to negotiate once your established for a year, is this true?

Everybody seems very helpful and I would love to hear the good and bad of the process to help me decide. I'm running my numbers and getting a spreadsheet and basic business plan together, so still in the starting stages. I hope these aren't too basic questions, I've combed through all the IMP stuff on the website and this was the one place that still seemed like a big black box.

Thanks,

April 5, 2011

Welcome Adolfo!A little tip for exam tables: I got mine from Craig's list. Since tables are so expensive to ship, getting locally is usually cheaper and I believe Craig's List allows you to search locally when Ebay does not (that I'm aware of).

SharonSharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com

April 5, 2011

I am in the process of dropping all the insurances I currently take where I am a residency faculty. (Boy it fells good to say that!) I sent faxes to them notifying them of same. Several called and wanted to know my new TID# so they could just switch me over. Even though I am not doing that, they seemed quite happy to keep me credentialed at my new place by just changing the details (location, TID) and not going through the whole credentialing process all over. So I think you could just send them a notice that you have a new TID, practice name, location, whatever and you're done.

Good luck,Deborah Ginsburg, MD

Hi ,

Welcome to IMP-dom. I would not recommend hiring a practice managment consultant to do the forms for you. We hired one who came highly recommended and all he managed to do in 2 months time was get the applications for us, when we thought he had already submitted them for credentialing. so we were 2 months behind in our credentialing from the get-go. I'd suggest that you do them yourself. Most insurance companies won't negotiate fees for a new practice, but you could suggest that you already know what they are paying you at your current practice and ask for at least the fees that they are paying you there. Theoretically, you aren't changing the way you practice, just where you practice, so they should pay you the same!

Depending on where you are located, your state or local medical association may have some sort of tool kit to help you wade through the credentialing process. I have a great wealth of information from the CMA, but we haven't had time or energy to renegotiate our contracts. As our practice fills up ( we define our " full " practice as one that has 2 or less empty slots every day for a month and when new patients cannot get into the office within 2 weeks, barring physician vacation or time away from the office), we will be reviewing them to see which ones we can get away with dropping. We hope that will be sometime this year or next. Before that happens, though, Steve is still working a second job and we would have him drop that second job to open up more time for patients.

Good luck,

Pratt

San Ramon, CA

Hello, everyone. I have been lurking for a few weeks and am finally ready start moving forward. I am considering leaving my current practice where I am an employed doc and have decided not to buy-in. I really like the idea of IMP and feel that it would be a great fit for the type of practice I envision. I am looking for a little guidance on the things that seem daunting to me...

Credentialling - it took about two months to get credentials done a few years ago when I started (established practice new provider), I'm not sure if that is a reasonable time line with a new practice if I am already a known entity to the insurers (I would hope to have similar panel to what I have now). I know that it is a boat load of paper work to do, and I have the off time to get this done. However, is there any benefit in hiring a practice consultant (haven't gotten firm estimate, but in the $2K range) just to complete this process and helping wade through the contracts with the insurers (they really aren't up on low overhead practices so wouldn't have them do any more than that). I know to look for language that indicates they can more or less lease you to other networks/insurers. Did any of you hire a lawyers to go through these contracts or just try to understand them to the best of your ability? I've heard there really is no negotiating reimbursement levels when you first apply, you just get what is customary for the area and have to negotiate once your established for a year, is this true?

Everybody seems very helpful and I would love to hear the good and bad of the process to help me decide. I'm running my numbers and getting a spreadsheet and basic business plan together, so still in the starting stages. I hope these aren't too basic questions, I've combed through all the IMP stuff on the website and this was the one place that still seemed like a big black box.

Thanks,

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

April 5, 2011

WelcomePractice consultants have not been helpful to IMPS as they do not understand our business model and gernally take yourmoney to tell youwhat you cannot do when-of course you can!Not useful

somewhere onthe wiki is brady's business plan You may have seen it already- I think here: http://idealhealth.wikispaces.com/bizplanOur annual conference is in October near Dc come and meet and learn

Tell us where you are?Jean

Hi ,

Welcome to IMP-dom. I would not recommend hiring a practice managment consultant to do the forms for you. We hired one who came highly recommended and all he managed to do in 2 months time was get the applications for us, when we thought he had already submitted them for credentialing. so we were 2 months behind in our credentialing from the get-go. I'd suggest that you do them yourself. Most insurance companies won't negotiate fees for a new practice, but you could suggest that you already know what they are paying you at your current practice and ask for at least the fees that they are paying you there. Theoretically, you aren't changing the way you practice, just where you practice, so they should pay you the same!

Depending on where you are located, your state or local medical association may have some sort of tool kit to help you wade through the credentialing process. I have a great wealth of information from the CMA, but we haven't had time or energy to renegotiate our contracts. As our practice fills up ( we define our " full " practice as one that has 2 or less empty slots every day for a month and when new patients cannot get into the office within 2 weeks, barring physician vacation or time away from the office), we will be reviewing them to see which ones we can get away with dropping. We hope that will be sometime this year or next. Before that happens, though, Steve is still working a second job and we would have him drop that second job to open up more time for patients.

Good luck,

Pratt

San Ramon, CA

Hello, everyone. I have been lurking for a few weeks and am finally ready start moving forward. I am considering leaving my current practice where I am an employed doc and have decided not to buy-in. I really like the idea of IMP and feel that it would be a great fit for the type of practice I envision. I am looking for a little guidance on the things that seem daunting to me...

Credentialling - it took about two months to get credentials done a few years ago when I started (established practice new provider), I'm not sure if that is a reasonable time line with a new practice if I am already a known entity to the insurers (I would hope to have similar panel to what I have now). I know that it is a boat load of paper work to do, and I have the off time to get this done. However, is there any benefit in hiring a practice consultant (haven't gotten firm estimate, but in the $2K range) just to complete this process and helping wade through the contracts with the insurers (they really aren't up on low overhead practices so wouldn't have them do any more than that). I know to look for language that indicates they can more or less lease you to other networks/insurers. Did any of you hire a lawyers to go through these contracts or just try to understand them to the best of your ability? I've heard there really is no negotiating reimbursement levels when you first apply, you just get what is customary for the area and have to negotiate once your established for a year, is this true?

Everybody seems very helpful and I would love to hear the good and bad of the process to help me decide. I'm running my numbers and getting a spreadsheet and basic business plan together, so still in the starting stages. I hope these aren't too basic questions, I've combed through all the IMP stuff on the website and this was the one place that still seemed like a big black box.

Thanks,

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

-- MD ph fax

April 6, 2011

Don't do Ebay for exam tables, unless local. Craigs list better, o/w you will pay a mint to ship. Also look for a used medical equipment place in your area, you should be able to get everything you need. CAQH is online, and so the form is the same for all insurers, it doesn't take much time, don't hire someone to do this, it truly is a waste of money. Negotiate price on space, on how many years, and everything else, lots of places sitting empty, also can just tell him what other empty spaces are charging. Try to get them to help you foot the bill on any build out, or changes that need to be made and wrap into the rent.

Cote. Getting Insurance Credentials

Hello, everyone. I have been lurking for a few weeks and am finally ready start moving forward. I am considering leaving my current practice where I am an employed doc and have decided not to buy-in. I really like the idea of IMP and feel that it would be a great fit for the type of practice I envision. I am looking for a little guidance on the things that seem daunting to me...

Credentialling - it took about two months to get credentials done a few years ago when I started (established practice new provider), I'm not sure if that is a reasonable time line with a new practice if I am already a known entity to the insurers (I would hope to have similar panel to what I have now). I know that it is a boat load of paper work to do, and I have the off time to get this done. However, is there any benefit in hiring a practice consultant (haven't gotten firm estimate, but in the $2K range) just to complete this process and helping wade through the contracts with the insurers (they really aren't up on low overhead practices so wouldn't have them do any more than that). I know to look for language that indicates they can more or less lease you to other networks/insurers. Did any of you hire a lawyers to go through these contracts or just try to understand them to the best of your ability? I've heard there really is no negotiating reimbursement levels when you first apply, you just get what is customary for the area and have to negotiate once your established for a year, is this true?

Everybody seems very helpful and I would love to hear the good and bad of the process to help me decide. I'm running my numbers and getting a spreadsheet and basic business plan together, so still in the starting stages. I hope these aren't too basic questions, I've combed through all the IMP stuff on the website and this was the one place that still seemed like a big black box.

Thanks,

April 6, 2011

Got an almost new exam table Ritter 104 for 350 plus 175 shipping. Not a bad deal. So look for the deals. Sent on the SprintÂ® Now Network from my BlackBerryÂ®From: magnetdoctor@...Sender: Date: Wed, 6 Apr 2011 00:26:25 +0000 (UTC)To: < >ReplyTo: Subject: Re: Getting Insurance Credentials Don't do Ebay for exam tables, unless local. Craigs list better, o/w you will pay a mint to ship. Also look for a used medical equipment place in your area, you should be able to get everything you need. CAQH is online, and so the form is the same for all insurers, it doesn't take much time, don't hire someone to do this, it truly is a waste of money. Negotiate price on space, on how many years, and everything else, lots of places sitting empty, also can just tell him what other empty spaces are charging. Try to get them to help you foot the bill on any build out, or changes that need to be made and wrap into the rent. Cote. Getting Insurance Credentials Hello, everyone. I have been lurking for a few weeks and am finally ready start moving forward. I am considering leaving my current practice where I am an employed doc and have decided not to buy-in. I really like the idea of IMP and feel that it would be a great fit for the type of practice I envision. I am looking for a little guidance on the things that seem daunting to me... Credentialling - it took about two months to get credentials done a few years ago when I started (established practice new provider), I'm not sure if that is a reasonable time line with a new practice if I am already a known entity to the insurers (I would hope to have similar panel to what I have now). I know that it is a boat load of paper work to do, and I have the off time to get this done. However, is there any benefit in hiring a practice consultant (haven't gotten firm estimate, but in the $2K range) just to complete this process and helping wade through the contracts with the insurers (they really aren't up on low overhead practices so wouldn't have them do any more than that). I know to look for language that indicates they can more or less lease you to other networks/insurers. Did any of you hire a lawyers to go through these contracts or just try to understand them to the best of your ability? I've heard there really is no negotiating reimbursement levels when you first apply, you just get what is customary for the area and have to negotiate once your established for a year, is this true? Everybody seems very helpful and I would love to hear the good and bad of the process to help me decide. I'm running my numbers and getting a spreadsheet and basic business plan together, so still in the starting stages. I hope these aren't too basic questions, I've combed through all the IMP stuff on the website and this was the one place that still seemed like a big black box.Thanks,

April 6, 2011

Welcome and all the best with your process. Let us know your plans as you get

them going...

I'm 4 years out from this but started in a new area so didn't try moving

credentialing or negotiating based on previous rates.

Agree that no consultant is needed for credentialing. It's just busy work. CAQH

helps.

I did not use a lawyer to review contracts, but you've got to make that

decision. It's not like you can get insurance cos. to change language. It's take

it or leave it as far as the language.

However, I found that I did have a little negotiating room on rates...as long as

I was willing to walk away. Negotiation was NO easier a year or two later.

Haresch

www.onefamilydoctor.com

>

> Hello, everyone. I have been lurking for a few weeks and am finally ready

> start moving forward. I am considering leaving my current practice where I

> am an employed doc and have decided not to buy-in. I really like the idea

> of IMP and feel that it would be a great fit for the type of practice I

> envision. I am looking for a little guidance on the things that seem

> daunting to me...

>

> Credentialling - it took about two months to get credentials done a few

> years ago when I started (established practice new provider), I'm not sure

> if that is a reasonable time line with a new practice if I am already a

> known entity to the insurers (I would hope to have similar panel to what I

> have now). I know that it is a boat load of paper work to do, and I have

> the off time to get this done. However, is there any benefit in hiring a

> practice consultant (haven't gotten firm estimate, but in the $2K range)

> just to complete this process and helping wade through the contracts with

> the insurers (they really aren't up on low overhead practices so wouldn't

> have them do any more than that). I know to look for language that

> indicates they can more or less lease you to other networks/insurers. Did

> any of you hire a lawyers to go through these contracts or just try to

> understand them to the best of your ability? I've heard there really is no

> negotiating reimbursement levels when you first apply, you just get what is

> customary for the area and have to negotiate once your established for a

> year, is this true?

>

> Everybody seems very helpful and I would love to hear the good and bad of

> the process to help me decide. I'm running my numbers and getting a

> spreadsheet and basic business plan together, so still in the starting

> stages. I hope these aren't too basic questions, I've combed through all

> the IMP stuff on the website and this was the one place that still seemed

> like a big black box.

>

> Thanks,

>

April 6, 2011

Re: eBay. We bought 2 exam tables, 2 stools, 2 chairs, a sphygmo and a few other small items all from 1 provider that was a 12 hour drive. We drove our pickup out, rented a u-haul to get it home, and had a mini-vacation that we could write off as a business expense with no kids. I'd do it again in a heartbeat.

Don't do Ebay for exam tables, unless local. Craigs list better, o/w you will pay a mint to ship. Also look for a used medical equipment place in your area, you should be able to get everything you need. CAQH is online, and so the form is the same for all insurers, it doesn't take much time, don't hire someone to do this, it truly is a waste of money. Negotiate price on space, on how many years, and everything else, lots of places sitting empty, also can just tell him what other empty spaces are charging. Try to get them to help you foot the bill on any build out, or changes that need to be made and wrap into the rent.

Cote. Getting Insurance Credentials

Hello, everyone. I have been lurking for a few weeks and am finally ready start moving forward. I am considering leaving my current practice where I am an employed doc and have decided not to buy-in. I really like the idea of IMP and feel that it would be a great fit for the type of practice I envision. I am looking for a little guidance on the things that seem daunting to me...

Credentialling - it took about two months to get credentials done a few years ago when I started (established practice new provider), I'm not sure if that is a reasonable time line with a new practice if I am already a known entity to the insurers (I would hope to have similar panel to what I have now). I know that it is a boat load of paper work to do, and I have the off time to get this done. However, is there any benefit in hiring a practice consultant (haven't gotten firm estimate, but in the $2K range) just to complete this process and helping wade through the contracts with the insurers (they really aren't up on low overhead practices so wouldn't have them do any more than that). I know to look for language that indicates they can more or less lease you to other networks/insurers. Did any of you hire a lawyers to go through these contracts or just try to understand them to the best of your ability? I've heard there really is no negotiating reimbursement levels when you first apply, you just get what is customary for the area and have to negotiate once your established for a year, is this true?

Everybody seems very helpful and I would love to hear the good and bad of the process to help me decide. I'm running my numbers and getting a spreadsheet and basic business plan together, so still in the starting stages. I hope these aren't too basic questions, I've combed through all the IMP stuff on the website and this was the one place that still seemed like a big black box.

Thanks,

April 6, 2011

In ebay, you can limit your search by distance away from you...

>

> Re: eBay. We bought 2 exam tables, 2 stools, 2 chairs, a sphygmo and a few

other small items all from 1 provider that was a 12 hour drive. We drove our

pickup out, rented a u-haul to get it home, and had a mini-vacation that we

could write off as a business expense with no kids. I'd do it again in a

heartbeat.

>

April 6, 2011

Cool. Didn't know that. Thanks.Sharon

In ebay, you can limit your search by distance away from you...

April 6, 2011

I bought mine local at a medical supply store for 150, and didn't need to be recovered, I just had to help haul it.

Getting Insurance Credentials

Hello, everyone. I have been lurking for a few weeks and am finally ready start moving forward. I am considering leaving my current practice where I am an employed doc and have decided not to buy-in. I really like the idea of IMP and feel that it would be a great fit for the type of practice I envision. I am looking for a little guidance on the things that seem daunting to me...

Credentialling - it took about two months to get credentials done a few years ago when I started (established practice new provider), I'm not sure if that is a reasonable time line with a new practice if I am already a known entity to the insurers (I would hope to have similar panel to what I have now). I know that it is a boat load of paper work to do, and I have the off time to get this done. However, is there any benefit in hiring a practice consultant (haven't gotten firm estimate, but in the $2K range) just to complete this process and helping wade through the contracts with the insurers (they really aren't up on low overhead practices so wouldn't have them do any more than that). I know to look for language that indicates they can more or less lease you to other networks/insurers. Did any of you hire a lawyers to go through these contracts or just try to understand them to the best of your ability? I've heard there really is no negotiating reimbursement levels when you first apply, you just get what is customary for the area and have to negotiate once your established for a year, is this true?

Everybody seems very helpful and I would love to hear the good and bad of the process to help me decide. I'm running my numbers and getting a spreadsheet and basic business plan together, so still in the starting stages. I hope these aren't too basic questions, I've combed through all the IMP stuff on the website and this was the one place that still seemed like a big black box.

Thanks,

April 6, 2011

Yep,

And we paid $200 for all of the equipment we got. Total cost of the trip (including purchasing equipment) was about $600 (gas + hotel + uhaul + purchase + meals). Not too bad for what we got!

In ebay, you can limit your search by distance away from you... >> Re: eBay. We bought 2 exam tables, 2 stools, 2 chairs, a sphygmo and a few other small items all from 1 provider that was a 12 hour drive. We drove our pickup out, rented a u-haul to get it home, and had a mini-vacation that we could write off as a business expense with no kids. I'd do it again in a heartbeat.

> >

--

Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

p.

f.

c.

www.prattmd.info

April 6, 2011

,

Start the credentialing process as soon as you can. We opened our practice 11

months ago and still not in-network with some private ones--some companies seem

to really drag their feet.

Don't hire anyone, nobody will do it as well as you, and there are

items/settings that will require your input anyway to get it done the way you

want (such as: credential under your name or the practice's name, specific

programs within an insurance plan you wish to participate in or not, etc.).

Start Medicare first (if you plan to take Medicare), as it is a long and tedious

process (but a more predictable one than some of the private insurances though)

and you can't enroll in Medicaid until you have your Medicare numbers, at least

not here. Having your Medicare numbers seems to be a basic that other

credentialing hinges on. And it is separate from anything you can do on the CAQH

website. CAQH is for private insurances only, I think.

Good luck!

Marfa Country Clinic

Marfa TX 79843

>

> >

> > Hello, everyone. I have been lurking for a few weeks and am finally ready

> > start moving forward. I am considering leaving my current practice where I

> > am an employed doc and have decided not to buy-in. I really like the idea

> > of IMP and feel that it would be a great fit for the type of practice I

> > envision. I am looking for a little guidance on the things that seem

> > daunting to me...

> >

> > Credentialling - it took about two months to get credentials done a few

> > years ago when I started (established practice new provider), I'm not sure

> > if that is a reasonable time line with a new practice if I am already a

> > known entity to the insurers (I would hope to have similar panel to what I

> > have now). I know that it is a boat load of paper work to do, and I have

> > the off time to get this done. However, is there any benefit in hiring a

> > practice consultant (haven't gotten firm estimate, but in the $2K range)

> > just to complete this process and helping wade through the contracts with

> > the insurers (they really aren't up on low overhead practices so wouldn't

> > have them do any more than that). I know to look for language that

> > indicates they can more or less lease you to other networks/insurers. Did

> > any of you hire a lawyers to go through these contracts or just try to

> > understand them to the best of your ability? I've heard there really is no

> > negotiating reimbursement levels when you first apply, you just get what is

> > customary for the area and have to negotiate once your established for a

> > year, is this true?

> >

> > Everybody seems very helpful and I would love to hear the good and bad of

> > the process to help me decide. I'm running my numbers and getting a

> > spreadsheet and basic business plan together, so still in the starting

> > stages. I hope these aren't too basic questions, I've combed through all

> > the IMP stuff on the website and this was the one place that still seemed

> > like a big black box.

> >

> > Thanks,

> >

>

> --

> * Pratt*

> Oak Tree Internal Medicine, PC

> 2301 Camino Ramon, Suite 290

> San Ramon, CA 94583

> p.

> f.

> c.

> www.prattmd.info

>

April 7, 2011

I still have 3 exam tables in a garage for anyone close enough to Westerlo, NY to come get them. No charge.

To: Sent: Tue, April 5, 2011 4:20:51 PMSubject: Re: Getting Insurance Credentials