Starting a new practice or joining an established one comes with a long to-do list. Between medical staffing, setting up billing systems, and handling patient care, there’s a lot to manage. One critical step that can’t be overlooked is provider enrollment and medical credentialing. Without proper credentialing, providers can’t bill insurance companies or get reimbursed for services. At Optometric Billing Consultants (OBC), we allow providers to focus on patient care while we handle insurance applications and approvals. Here’s what every new provider should keep in mind:
What New Providers Need to Know About Credentialing
Start the Provider Application Early
Credentialing isn’t instant. Most insurance companies take 60-120 days to process a provider application, and missing a step can cause delays. It’s best to begin as soon as possible to avoid gaps in reimbursement eligibility.
Accuracy Matters
Applications with errors or missing documents often get rejected or delayed. Insurance companies require detailed records, including licensing, work history, malpractice insurance, and references. Double-checking information before submission prevents unnecessary setbacks.
Keep Up with Re-Credentialing Deadlines
Providers must renew their status periodically to stay in-network. Each insurance company has different renewal schedules, so tracking deadlines is key to avoiding interruptions in billing. Missing re-credentialing dates can result in delayed claims, causing revenue gaps that can impact your practice.
Not All Insurers Have the Same Requirements
Every insurance provider has its own set of rules for enrollment. Some require extensive paperwork, while others have digital applications. Understanding the differences helps prevent wasted time on incorrect submissions. For optometrists, insurers like Medicare or private payers may request specific forms or proof of optometry board certification, while others may require detailed patient care documentation from your practice.
Even the best medical billing services can’t function if providers aren’t credentialed correctly. Let Optometric Billing Consultants handle the paperwork to get your claims processed and payments accepted. Contact us today to get credentialed without the headache!