(Updated March, 2024)
Becoming an in-network physical therapist can be a complex and time-consuming task. However, the physical therapy credentialing process is a valuable component of your physical therapy practice. To help you solve credentialing challenges in an expedited and accurate manner, let’s explore the ins and outs of credentialing for private practice clinics and explain why outsourcing this process may be beneficial for clinic owners.
Why Physical Therapy Credentialing Matters
Credentialing is the process through which payers evaluate a provider’s education, training and professional history before contracting with them.
Getting into insurance contracts isn’t easy, but it’s a crucial step for you to level up your physical therapy practice. It will also allow you to treat patients with insurance coverage and help you establish credibility within the healthcare network.
4 Key Steps for Getting Your PT Clinic Credentialed
1. Determine When to Obtain New Credentialing
Whether you’re opening a new practice or adding a new employee, understanding when you need to undergo the credentialing process is essential. Each time a physical therapist joins your clinic, you must go through the entire credentialing process again, even if they were previously contracted with a payer.
2. Collect Required Paperwork
The insurance credentialing process requires extensive documentation. Ensure you gather the necessary paperwork in advance, including an up-to-date curriculum vitae, NPI number, proof of malpractice insurance, state license, PT diploma, training certificates, tax ID/Employer Identification Number (EIN), proof of physical location among other forms of paperwork.
3. Submit Applications at the Right Time
Timing is crucial when submitting credentialing applications. Commercial payer and workers’ comp applications can take four to six months for processing. However, Medicare credentialing can only begin once you open your doors and start treating patients.
4. Choose the Right Payers
Before sending out credentialing applications, research if your desired payers have open or closed panels. Closed panels are not accepting new providers, so it’s best to prioritize open panels. Additionally, consider marketing to patients with other regional insurances and explore offering out-of-network or cash-based services.
The Benefits of Outsourcing Physical Therapy Credentialing
Outsourcing the credentialing process for your private practice can bring significant advantages to clinic owners. By partnering with experienced credentialing service providers like MEG Business you can:
Save Time and Effort
Outsourcing allows you to focus on patient care and other aspects of your practice, while experts handle the time-consuming process of credentialing. Our credentialing service acts as an extension of your team with a dedicated representative.
Ensure Compliance
Our professional credentialing staff are well-versed in payer requirements and can ensure your documentation and applications meet the necessary standards, reducing the risk of rejections or delays.
Optimize Reimbursements
Credentialing services can help negotiate favorable fee schedules, ensuring you receive timely and fair payment from insurance companies. We’ll also send you bi-monthly reports and update your clinic database with submitted and completed forms.
Receive Industry Specific Advice
By using a physical therapy credentialing expert like MEG, you’ll have access to specialized expertise that will help you navigate the requirements, regulations and challenges that PTs face during the credentialing process. In addition, our experts have established relationships with insurance companies specific to the physical therapy field. Compared to other healthcare credentialing services, we can help you maximize your chances of successful accreditation.
Outsourcing Credentialing with MEG Business Management
Don’t just take our word for it, either. Many physical therapy clinic owners are choosing to outsource their credentialing with MEG. Beth Andrews, Owner of Momentum Physical Therapy & Wellness, had this to say about her experience with MEG’s credentialing service:
“I want you to know I couldn’t be more pleased having Katie McGinnis in charge of the credentialing for our new practice. Katie is so great at what she does that she completely wiped out the fact that I was behind schedule in the credentialing process. Thank you, Katie! And thanks to everyone at MEG who we’ve had contact with—you have helped us succeed. If you’re like me and knew all along you wanted credentialing and billing outsourced and had not yet found the right place, MEG will be just what you need. Timely payment from insurance companies has been a pleasant surprise too.”
Streamline the Credentialing Process; Discover the Benefits of Outsourcing
Credentialing is a vital step for PTs in establishing relationships with payers and gaining in-network status. By understanding the credentialing process, collecting necessary documentation and considering the benefits of outsourcing with trusted providers like MEG for your business coaching and credentialing services, clinic owners can streamline the process and unlock the advantages of working with payers.
Request a free credentialing assessment from MEG to kickstart your journey toward efficient credentialing and enhanced practice success.
