One of the biggest misconceptions I see is that once you're approved with an insurance company, you can immediately start billing. That's not always the case. This only applies to new contracts and newly credentialed providers. For new contracts, most insurance companies have a separate loading process that happens after your credentialing has been approved. During this process, they add your information to their claims system, including your NPI, Tax ID, practice information, fee schedule,...

The first question I ask clients is do they want to have the flexibility to add/credential another provider with their practice at any point in the future. This guides us to determine what the next steps are and how they should credential their practice. If the answer is yes, then we need to make sure they have a group NPI. The group NPI When you credential with the insurance payers, you can enter into a contract using your Individual NPI (type 1): Individual/solo agreement OR Group NPI (Type...

If you're credentialed with insurance companies, you've probably started seeing references to DataSpring. That's because CAQH has officially rebranded. The good news: from a provider perspective, nothing is changing operationally. DataSpring is still the platform insurance companies use to obtain provider information for credentialing, enrollment, provider directories, and other administrative functions. Your login, profile, attestation process, and workflows remain the same. If you've used...