Addiction Treatment Credentialing have become absolutely necessary for medical practices who have taken it upon themselves to combat the crisis of substance abuse disorder.
The Addiction fighting workforce today is represented by at least 100,000 counselors, healthcare professionals, and educators. These professionals help in the treatment, recovery, and support of individuals suffering from substance issue problems.
However, rendering of such treatment and recovery process becomes impossible for medical professionals if they fail to get credentialed with government or private medical agencies like Medicare, Medicaid, Aetna, etc. Private and group practices cannot offer addiction treatment or collect payments from patients who are covered by the federal insurance program.
Addiction Treatment Credentialing – What is it?
Credentialing is the process of assessing the legitimacy and background of a medical practitioner and establishing the qualifications they require to become licensed professionals. The concept is simple and is designed to protect ailing individuals from being exploited by fraudulent practices.
With the help of Addiction treatment Insurance credentialing, healthcare professionals have the necessary license requirements to legally serve new patients and get paid by these patients for the services they perform.
Why Get Addiction Treatment Insurance Credentialing
Rising Substance Abuse Disorder (Crisis)
The crisis of addiction our nation faces today is the stuff of nightmare. In 2017 alone, 70,000 Americans died of a drug overdose. This includes prescription opioids, heroin, and illicitly manufactured fentanyl abuse. The death rate has gone up from 6.2 per 100000 people in 2000 to 14.2 per 100000 people in recent years.
The numbers signal the imminent demand for Medical practitioners who have the skills and qualifications needed to provide medical attention to a population of people suffering from Substance Abuse Disorder.
Probably one of its vital benefits is how it can get a medical practice onto an insurance panel, or better yet turn them into an in-network provider. This allows for dealing with billing codes, rates, and other reports and deliverables consistently. The overall uniformity this system offers can help healthcare enterprises make essential decisions more effectively and efficiently.
Better Customer Support
As many insurance companies, today have their own team of autism specialists, in-network providers such as licensed medical practitioners have the chance to socialize and build valuable relationships within the organization that can help with faster claim resolution, or helps resolve queries regarding claim issues. This allows for pre-authorization, re-authorization, and claims information online. All of these factors ultimately enable clinics to provide better customer support to their customers.
Getting credentialed allows medical practices to send bills to insurance providers electronically. Electronic claims are a faster, more convenient way of receiving payments quickly than traditional paperwork. Unfortunately, this benefit cannot be enjoyed by medical practices that don’t possess the necessary credential requirements.
The Process of Getting Addiction Treatment Credentialing.
The Addiction Treatment Credentialing process is a long and complicated one. The whole process can take between 90 and 120 days to culminate. It is highly recommended that the credentialing process be started as soon as possible, especially for new medical practices.
You also have to be ready to take 45-minute calls every day while your application is under process. Hence due to its length of time and complicated nature, it is highly advisable to seek the help of third-party support like denmaar who can get the job done for you.
The following is the process to get Addiction Treatment Credentials.
1. The first step towards getting credentialed requires medical firms to apply for an NPI aka National Provider Identifier. An online application requires the input of information like social security number, BCBA certificate number or BCaBA certificate number, Taxonomy code for behavioral analysts, and BA license number if applicable. The NPI is usually acquired within a day and is essential to receive reimbursements for ABA services with any carrier.
2. After the acquisition of NPI, the next step is to become a member of The Council for Affordable Healthcare. A medical practice can only become a part of CAQH. The medical practice needs an invitation from the insurance provider. Once the firm can log in to the CAQH system, they are required to submit a plethora of information such as employment history, references, resume, and W9, BCBA, or BCaBA certificates, educational history, information about medical practice.
3. After the application is completed, insurance companies will have access to the information provided. They will use the information to verify it with their agency.
Stop Losing Patients with Insurance
Medical practices need to be privy of all the plans and terms of coverage offered by insurance companies. Almost all Americans are enjoying the benefits of some of the other health insurance programs. Without the necessary credentialing requirements, there is no point in even starting a medical practice that treats addiction, no matter how noble your intentions may be.
Addiction Treatment Insurance Credentialing is essential for medical practices to continue to accept new patients and receive payments to justify their services. The process to get credentialed can be tedious, a problem that can be alleviated by hiring third party professionals like denmaar who can do the heavy lifting for a medical practice.Learn More