DENmaar: Streamlining Clinical, Administrative, and Billing Operations for

BCBS aka Blue Cross Blue Shield Association is a widely recognized federation of 36 separate Health Insurance organizations, and Companies. This association, which includes different well-known insurance providers, covers more than 106 million citizens in America. Publicly traded and privately owned insurance companies like Anthem, CareFirst, Highmark, Premera, Cambia Health Solution, etc. are all part of the BCBS Insurance Credentialing Services.

As such, applying for BCBS Provider Credentialing is crucial for practitioners who seek to tap into the pool of potential clients who are covered by the Blue Cross Blue Shield Association. Now, becoming an in-network provider is a three-part process. It is lengthy and fairly complicated. It is advisable for the group and private practices to seek help from third-party credentialing service providers like DENmaar to simplify the entire process.

  Let us look into the BCBS Credentialing Process:

As mentioned before, becoming an in-network provider with BCBS is a three-part process.

• •     Getting Credentialed or Re- Credentialed with BCBS
• •     Register Your NPI (National Provider Identifier)
• •     Have a Signed Contract with BCBS in your state.

1 – Getting Credentialed or Re- Credentialed

BCBS first checks the credentials of medical practitioners who apply for Insurance Credentialing Services. They have to submit their resume, work history, and other vital information for the purpose of background verification. The applying party can send their applications and documents online or manually.

Online application with BCBS Insurance Credentialing Services is only exclusive to providers. The information is sent to the Universal Credentialing DataSource (UCD). BCBS works closely with the Council of Affordable Quality Healthcare, thus making the entire process quite simpler.

BCBS Provider enrollment also requires that facilities that are not providers have to send their applications manually.

2 – Obtain an NPI (National Provider Identification Number)

The NPI, also known as National Provider Identifier, is a ten-digit unique identification number used to replace provider identifiers such as the unique provider identification number in HIPAA standard transactions.

Healthcare providers must obtain an NPI in accordance with HIPAA regulations. AN NPI should be obtained before applying to get into BCBS network.

3 – Get a Signed Contract with BCBS

Before getting a signed contract with BCBS you have to register your NPI Through the enrollment application process. You need to register to be able to access Explanation of Payments (EOP), and sign an EFT to receive claims payment.

The entire process can take 30 – 45 days from the date of NPI enrollment.

As you can probably guess by now, becoming an in-network provider with BCBS can be a very long and tedious process. The entire BCBS behavioral health credentialing process requires at least 90 – 120 days to be completed and approved. There is a lot of paperwork, which makes the whole process quite frustrating for medical practitioners who want to accept clients with medical insurance. There is also a higher risk of application rejection when you go about the BCBS credentialing process alone.

That is where the professional assistance of DENmaar comes into play. With the help of our BCBS Insurance Credentialing Services, we can walk you through the entire process without any complications and hassle so that you can work on other core areas of your medical practice.

  Benefits of utilizing DENmaar’s Credentialing and Enrollment Services

The following benefits await those who seek DENmaar’s Blue Cross Blue Shield Provider Credentialing.

• •     Get Assisted by Highly Skilled BCBS Credentialing Experts
• •     Get Credentialing Assistance from Start to Finish.
• •     Our Credentialing experts ensure your applications are submitted to BCBS on time. 
• •     We regularly follow up with BCBS at your behest to get updates on your applications
• •     We will help you update your CAQH profile
• •     Get real-time status updates with a real-time RCM portal
• •     Stay informed and get alerts on expiring documents on time.

  Who We Help with Blue Cross Blue Shield Provider Enrollment

• •     Physicians
• •     Physician Assistants
• •     Nurse Practitioners
• •     Urgent Care Facilities
• •     Audiologists
• •     Behavioral Health Providers
• •     Physical, Occupational, and Speech Therapists

  Join BCBS as an In-Network Provider with DENmaar

Getting on the BCBS network is no easy task. However, it is essential if you want to accept and care for patients with BCBS-sponsored health insurance. At DENmaar, we offer end-to-end BCBS Credentialing services that help your behavioral health practice expand its reach and provide care to more patients in the process. You can rest easy knowing that our credentialing experts will be working closely with you and guide you throughout the often long BCBS Provider enrollment process. 

We are home to credentialing specialists who possess the insight, experience, and resources needed to get you to that credentialing finish line without a hassle. We will make sure your claims filed are clean to avoid claim rejections and accelerate the process of getting you in-network with BCBS. 

With DENmaar by your side, you can expect to overcome BCBS’s credentialing challenges effortlessly while making sure that other core areas of your healthcare enterprise receive your undivided attention.

Contact us at DENmaar, to start your journey to becoming an in-network provider with Blue Cross Blue Shield

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  Let’s discuss the Cigna Insurance Credentialing Process.

Cigna is a popular American health service organization based in suburban Bloomfield, Connecticut, and Philadelphia, Pennsylvania. Their insurance subsidiaries are major providers of mental, dental, accident, and life insurance to American citizens.

Cigna is known to provide Medicare and Medicaid programs to an individual in the U.S. and some international markets. Hence many physicians and medical practitioners want to become participants in the Cigna healthcare network. To become a participant, however, healthcare services need to apply for Cigna Insurance Provider Credentialing.

As we mentioned, Cigna has an extensive network of people who subscribe to their health insurance. If accepted as part of the network, a medical service provider naturally becomes an in-network provider and people with Cigna plan will be more inclined to use their particular medical service.

  The Process to Apply For Cigna Health Insurance Provider Credentialing 

The entire process of applying to get into any insurance provider network can be long and complicated. However, it is necessary to tap into those clients who have insurance, thus making the process mandatory to run a successful medical practice.

1. Pre Application

Before applying, Cigna requires practitioners to handover some necessary information to confirm that the applying practitioner is meeting basic guidelines of insurance credentialing with Cigna.

A Cigna health Insurance Credentialing representative is assigned to the practitioner who informs whether the applying party meets all the mandatory guidelines or not.

2. Submit Your Application

Once the practitioner is deemed compliant with Cigna’s guidelines, they send an e-mail with an application packet containing all the information needed to get started.

If the application information already exists on the CAQH aka Council for Affordable Quality Healthcare exists on the CAQH or One Healthport website, then Cigna Insurance Credentialing will with the applying parties permission, proceed to access it electronically.

The Following application information is required from the applying party, depending on:

•  State Medical or appropriate professional License
•  Drug Enforcement Agency Certificate (Mandatory)
•  Controlled Dangerous Substances Certificate (Mandatory)
•  Cigna participation in-hospital clinical privileges
•  letter of interest for insurance credentialing for Cigna
•  Board Certification Status
•  Professional and Educational Training
•  Work History
•  Malpractice Claims History
•  Adequate Malpractice Insurance
•  Prior Sanctioning Activities

3. Follow Up

Once Cigna receives the application packet, they will start the credentialing process. The entire process will take 45 to 60 days to complete.

During this time, the applying party will receive e-mails regarding:

•  Confirmation of Application received
•  Request any missing documentation or application information. If any fundamental document or information is found to be absent during the process, Cigna Insurance Credentialing will send a notification, notifying about the closure of that particular application.
•  Constant updates about the status of an application, including delays if any.

4. Cigna Approval

If Cigna approves a particular practitioner’s application, the practitioner becomes an in-network provider with Cigna. Cigna will update the provider information in their database within the next 10 business days.

Being a Cigna Insurance Credentialing in-network provider can be a very long and tedious process. The entire process requires at least 90 – 120 days to be completed and approved. There is a lot of paperwork, which makes the whole process quite frustrating for medical practitioners who want to accept clients with medical insurance. That is where the professional assistance of DENmaar comes into play.

With the help of our credentialing experts, we can walk you through the entire process by accomplishing tasks like updating credentialing with insurance Cigna, without any complications and hassle so that you can work on other core areas of your medical practice.

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Mental health Insurance Credentialing for psychologists and counselors have become extremely important today. Mental health specialists, just like other practitioners, need to go through an extensive credentialing process to validate their practice.

By forsaking credentialing, a practitioner compromises on a good number of clients covered under the federal insurance program. With a clamoring for more progressive ‘medicare for all idea floating in the United States political spectrum, credentialing has never been this urgent for mental health specialists.

Mental Health Insurance credentialing and billing for mental health professionals

Now, if we assume that a physician works on a $100/hr, pay, that’s approximately $20000/year in credentialing work per physician. This is excluding any paperwork; of course, you lose more money if you lose relevant documents.

In hindsight, you are spending way more than $20000/year. Credentialing services cost way less when outsourced to a third health insurance credentialing specialists like Denmaar.

Credentialing Cost Breakdown

Individual Practitioner Cost – 100-200$ per physician

CAQH Database

Initial Setup Cost can go up to $200-$500

Panel Application Cost

Practitioners should expect to pay $100 per panel

So, on average, the general cost of physician insurance credentialing services is somewhere between $2000-$3000/ year.

Most of the cost incurred in the process of Mental Health Insurance Credentialing services is because of its lengthy nature. You lose money if you lose your documents. You lose money, if you fail to follow-up with the insurance companies, resulting in the expiration of your application. The entire process has too many pot-holes for medical practices to crash and burn.

Hence, it is highly recommended to use the help of third-party experts like Denmaar for Mental Health Insurance panel credentialing.

Mental Health Insurance Credentialing Process

1.Getting Your Information in Order

As we mentioned before, credentialing requires a lot of information and documents from the
practitioner.

They are:

•  Licensure Information
•  NPI Number
•  Resume
•  Proof of Malpractice Insurance
•  Taxonomy Code
•   Proof of Liability Insurance from Landlord (Applicable on if you are renting)
•   Credentialing Paperwork

2. Fill Out Your CAQH

You will find many companies who use the Council of Affordable Quality Healthcare for the purpose of credentialing. Before filling out the CAQH form, you are required to hold an authentic resume with no gaps in employment. The application is supposed to be completed online via the CAQH hub.

The entire process can be extremely confusing to follow, but we at Denmaar assist you till the end.

3.Contact provider Relations

Once you have gone through the CAQH process, you are now afforded the liberty of choosing which insurance panel you want to be on. The insurance companies you choose may vary in the department of reimbursement rates, provider friendliness, payment speeds, etc.

Some companies may have their own sets of rules and requirements to apply. Now here you might face an issue of rejection, or not being accepted because the panel is full.

In such cases, you can do the following to build relationships with networks to gain access for future openings:

•  Evening and Weekend Availability
•  Experience with special populations
•  Crisis services
•  Handicap accessible facilities
•  Being located in an underserved area
•  Multilingual fluency
•  Having an in-network referral source.

4.Submit Application

Once you have taken care of the documentation and decided on which insurance panel to join, it’s time to submit the application and wait. The entire process of getting paneled is relatively swift, culminating within 9-10 hours.

All you have to do now is a follow-up. You have to keep tabs on the status of your application. Chances are it might expire while still in the process if taken too long, and you don’t want to start again. The insurance companies have to be notified every time you submit a document to ensure it has reached them.

5.Review after Approval

Once you have received approval, it is still not an appropriate time to celebrate. Do the following to be on the safer side.

•  Review your contract carefully before signing
•  Keep a file with the agreement and any addendums ready for future reference.
•  Learn more about the insurance provider’s portal on its official website.
•  Collect a list of phone numbers for the claims department, pre-authorization department and provider relations.

Once you have taken care of the above bucket list, you are ready to sign. To speed up the process, Denmaar’s will help you submit your claims electronically. This will help you save time, money, and paper.