Never Miss a Call, Intake
Opportunity, or Scheduling
Request.

Getting on insurance panels requires one very crucial step. We are of course talking about CAQH registration. A provider needs to complete his CAQH profile to even entertain the idea of getting onto an insurance panel.

CAQH aka council of affordable quality healthcare is a program that allows insurance companies to use a single application system for all kinds of credentialing. Today, over 900 clinics, health plans and healthcare organization are estimated to be using it. They require a practitioner to complete their CAQH profile by filling up the CAQH attestation form mandatorily in order to submit their application.

The process although very simple in its premise, can be a little confounding for some to follow. That’s why we have decided to guide you through the entire process to avoid any room for doubts, so you can have a hassle free credentialing experience.

1 – Getting a CAQH Number

Many start their credentialing process before even approaching the CAQH profile. Chances are high that your insurance company is already using CAQH. You can check the list of participating organizations on the CAQH website to confirm this. If a particular company is using CAQH, then they send you a CAQH id number, probably in a letter via mail. You should wait for at least 2 weeks to ensure your application is received by the panel. If you still don’t receive it, then it’s time to give your insurance company a call.

Alternatively, you can choose to register yourself on the CAQH website. As such, you will receive your CAQH number via email. Do not lose this number as you will need it throughout the credentialing process. You need it to fill up your application and re-attest your information.

2 – Have all your information ready

The CAQH process is tedious and time consuming. Nobody expects you to finish it in one sitting as it can literally remove hours from your life. One way to speed up the process however is to make sure you have all the information and material you will need for processing ready.

Here’s a list of all the things you’ll need before you start filling up the CAQH attestation form

• •     Personal information
• •     Education and training information’
• •     Practice location information with certification, address, contact detail, practice type etc. mentioned
• •     Board certification
• •     Disclosure of malpractice history
• •     Malpractice insurance information
• •     Work history

And the materials you’ll need are as follows

• •     Resume
• •     State licenses
• •     Malpractice insurance policy
• •     UPIN, NPI and other ID numbers
• •     DEA certificate (if necessary)
• •     CDS certificate (if necessary)

Make sure all your information is accurate. Your resume should be formatted with the correct date format, which is MM/YYYY, and there should be no gaps in employment. Failure to abide by any of the above requirements can lead to the rejection of your application. So do not rush into your application. Take your time to make sure everything is in order. Remember, errors can cost you way more time and money. Finally, you need to have scanned copies of all the required material in handy as you will be required to upload it.

3 – Start Working on Your Profile

Once you have all the information you need, it’s time to start completing your CAQH profile. We recommend you only undertake this task online. Doing this physically means tackling a dozen pages long application form that only prints correctly in color and cannot be transferred conveniently without a data entry professional to assist you.

Like we said before, you simply cannot complete the profile in one sitting. So take your time, save your progress and continue later. Once you’ve finished the profile click ‘next’. The website will ask you to verify your information once and ask you to attest whether all the information you provided is accurate.

Once you attest, you will receive a message that your profile is complete. Once you’re done, you have a choice to make. You need to make a decision as to who gets to access your profile, whether you will allow any insurance company that exhibits interest in having you on your panel, or choose manually which insurance company gets to see your profile and which company doesn’t.

In our opinion, the first option is the best as it will open you to more possibilities of being invited on multiple insurance panels. Make sure to never lose your application information as you will be required re-attest to the information once in a while, or on a quarterly basis. Respond to the request to re-attestation quickly as not doing so can result in insurance companies refusing to pay your claims.

What constitutes the best medical billing software for mental health services? Is it an excellent user interface? Or Is it the ability to perform all tasks like scheduling, appointment booking, tracking payments, and billing automatically? Ask this question to a mental health practitioner, and the answer would be all of the above.

And why not? Why not have software that is not only easy to use but also relieves doctors and practitioners from the hassles of everyday billing and payments.

Keeping this frustration in mind, DENmaar set on a journey to bring the mental health industry a medical billing software that would work to rid mental health practitioners of their payment-related hassles. Our billing software comes with an easy to comprehend user interface that would fit right in with your daily medical choirs.

With a hard-earned reputation, DENmaar specializes in professional and facility billing for insurance claims and patient responsibility. Our clients receive our RCM and Mobile apps to easily create charges, which we later submit to insurance and bill patients. All associated expenses are included when used with our insurance billing services.

DENmaar’s fully automated and highly advanced software was developed to bring our clients the benefits of both professional and institutional billing. State of the art insurance claims processing will keep organizations and providers ahead of the game with automated eligibility verification, claims status updates, claims rejections and denial resolution processes.

Our system also allows for the tracking of your claim status. If due to some unfortunate circumstances, your claim does get rejected and denied, then our experts are at your service to take the necessary actions needed for the approval of your claim.

  What makes DENmaar’s Medical Billing Software Special.

Improved Patient Payment System

DENpay is HiPAA compliant and integrates a Virtual Terminal within our RCM to create a conveniently seamless way for patients to make their payments. For providers, it automates the entire payment tracking system and reconciling patient payments. Patients can safely store credit cards and balances automatically billed. Other payment options include emailing a blind statement requesting payment or making a payment with our patient apps. Statements may also be mailed by clicking a button, no printing or stuffing envelopes. How much does this patient payment system cost our clients? $0 It is included as a complimentary feature when using our insurance billing services.

Claim Issues Resolved

Claims which have been denied and rejected are immediately followed up on by DENmaar’s team. We leave no room for such claim issues to occur. Each account has a dedicated Claims Resolution Specialist, a Credentialing Specialist, and an Onboarding Specialist to handle adding insurance panels for billing. That is why DENmaar has a very high first-time claim submission pass through. Payments come in a timely. This allows for cash flows to be maximized, thus making an organization witness its highest revenue generation period.

Staff Claim Tools

All of our software modules, provider and patient apps include Intake and Assessment forms, Telehealth, Electronic Prescription and EMR, Scheduling, Eligibility Verification. Service accounts may use any or all of our features, we provide it as a complimentary product. Our system is cloud based, making transitioning to our platform a breeze.

  Choosing DENmaar

DENmaar has been working in the behavioral health industry since 2008 and understands the challenges of a practitioner engaged in within the specialty. Our medical billing software was designed and constructed keeping mental health medical billing in mind. By utilizing our own proprietary RCM system for claims processing we ensure continual advancement in this important financial area. The additional clinical tool for both therapists and medical doctors is a unique feature not typically found in a therapy notes product. We believe we are positioned well now and in the future and would like to take hard working mental health providers with us as we work together to serve the needs of an increasingly needed medical service.

Even as the Affordable Cares Act gains momentum, many Americans still don’t have access to health insurance. There can be a number of reasons for such a plight. It can be because patients simply cannot afford to purchase health insurance, or they simply fall through the cracks because of residing in states like Florida who didn’t expand on their existing healthcare plan.

As such, self-pay patients are becoming more common. However, many can’t find themselves proper care as practitioners are still reluctant in accepting self-pay patients or don’t have patient payment centers that undertake such practice. So to encourage doctors to accept more patients of such nature, we are going to explore some tips and tricks that can help doctors accept self-pay patients with ease.

But first, let’s understand the reason behind the reluctance of so many doctors in accepting self-pay patients.

The Issues with Self Pay 

It is estimated that approximately 81 percent of revenue collected from patients is never really recovered when it is self-paid.  Add to this woes, almost 30 percent of patients are said to default on their bills. 

Keeping these figures in mind, it is not difficult to understand why doctors are reluctant. Enabling Self-pay sure seems like a recipe for disaster for the functioning of any healthcare organization. However, there are effective ways to ensure there is a perfect patient payment plan in place to avoid the above scenarios of loss.

Establishing an Efficient Policy

Before accepting self-pay patients, it is highly imperative to have some formal payment policies in place. This will protect doctors from losses and payment defaulters. There are 4 factors that must be considered while establishing this policy.

1 – Insurance Co-pays

Set up the office to accept both cash and credit payments, as patients are responsible to fulfill their own co-pays anyways.

2 – Referrals

Referrals are required by insurance companies to recommend patients with specialists they should visit. It forms a big aspect of the primary care providers business.

3 – Payment Responsibility

Providers should set up convenient patient payment centers to allow patients with as much convenience as possible in making payments. Introduce the option of online bill payment to ensure bills are paid on time.

4 – Past Payments

Have a policy to ensure collection of past dues, not a single outstanding payment should be allowed to slip through the cracks.

Creating a formal payment policy will ensure each of these 4 problems are taken care of efficiently. The payment policy should be available on your practice’s website or in print hanging in your practice premises wherever it is visible to your visitors.

Does your Self Pay Patient have hidden healthcare coverage?

Many self-pay patients are opting to pay from their own pockets because they don’t have healthcare coverage. Check their records thoroughly for any past healthcare benefits they can exploit. Also, most self-pay patients do not remain the same as time progresses. They might opt for a health insurance program because they could probably afford healthcare now.

Implement a comprehensive healthcare insurance checklist to ensure a patient isn’t paying more than what he is required to, and that you as a provider are getting paid correctly and on time.

The Bottom Line

As you can tell by now, self-pay patients enjoy a bad reputation in the healthcare industry. However, they are also humans and in need of health care. Care providers can ensure flexible payment options, and clearly communicated payment policies to ensure patients receive the care they need, and providers get paid for the services rendered. Providers can state in their policies that payment is due when services are rendered, thus automatically setting a deadline for payment of dues.