Maximizing Healthcare Efficiency: Mastering CAQH and Provider Credentialing

Поділитися
Вставка
  • Опубліковано 29 січ 2025

КОМЕНТАРІ • 13

  • @sharondagordon6206
    @sharondagordon6206 4 місяці тому

    What are the steps to take if the payor is unable to pull the providers application from CAQH?

    • @NavigtingtheBusinessofMedicine
      @NavigtingtheBusinessofMedicine  4 місяці тому

      When you say “unable” do you mean because of a technical issue? If that is the case then you’d need to work with CAQH directly for a solution. There is a new place under settings in each user’s login where permissions have to be granted to insurances to view that particular provider’s profile. Be sure to check that is enabled too. If it is a payor that doesn’t use CAQH for credentialing, then you need to provide all the information they require. Generally, the payor will have their own application or portal to enter all the information. You should be able to find this information on their Provider Enrollment webpage or by calling them to ask. Good luck!

  • @fyi6961
    @fyi6961 3 місяці тому

    All courses is it available udemy??

  • @fyi6961
    @fyi6961 3 місяці тому

    I do not have access to buy these courses.. i am from out of usa country. If u add all courses in udemy it would help me .
    Thank you

    • @NavigtingtheBusinessofMedicine
      @NavigtingtheBusinessofMedicine  3 місяці тому

      Thank you for the suggestion. I will do some research into this platform to see if I can start offering them here as well. I appreciate you watching!

  • @adasanchez6445
    @adasanchez6445 Рік тому

    Hi, your videos have been incredibly helpful. Thank you! I recently started using CAQH and I’m trying to figure out how I can delete the COI that has expired. Again, I can’t thank you enough for all your help.

    • @NavigtingtheBusinessofMedicine
      @NavigtingtheBusinessofMedicine  Рік тому

      I wish I could help you because I know that I have done it before, or at least marked it in active, but it’s been a while since I have been in there and without being able to see it it makes it difficult for me. As long as it’s expired or marked in active and you put a new one in there, it should be fine, thanks for watching!

  • @tremealmanley1865
    @tremealmanley1865 7 місяців тому

    I am the Owner/Administrator of a BHRF in Arizona. We’re not able to apply for an AHCCCS provider number, the States public healthcare plan, because of a moratorium on new providers. This has greatly hampered our efforts to fully open and accept residents into our facility. The only option we have is to target cash payers. How can applying in CAQH database help us in finding billable residents/clients to prevent closing of the business? Does our BHP need to be in the CAQH database for insurance companies to refer residents to our facility?

    • @NavigtingtheBusinessofMedicine
      @NavigtingtheBusinessofMedicine  7 місяців тому

      Hi there and thank you for watching. I’m sorry to hear of the struggles you’re experiencing. CAQH is used by insurance companies when getting providers credentialed. Not all companies use it. To be referred by an insurance company to your business, you first need to be contracted as an organization with each insurance company and then they will put your providers and group in their online directory under your specialty and address. For other referrals from colleagues, you would need to market yourself to other groups in your area so they know about you and your services. Good luck!

  • @betelhemseleshi2978
    @betelhemseleshi2978 Рік тому

    Hi, I came across your channel on UA-cam and you share some vital information, thank you!
    I own an independent Ultrasound facility and I am interested in getting my office credentialed with insurance companies in the area(Maryland). I do have a medical director that oversees my office and I guess my question is that is it all his info that I need to put in when creating CAQH?
    Thank you

    • @NavigtingtheBusinessofMedicine
      @NavigtingtheBusinessofMedicine  Рік тому

      Does the Medical Director read the results and do you bill for the readings? If so, then yes he would need to be credentialed with all the insurances you will be billing. To become credentialed, the provider would need a CAQH profile created and/or updated for this purpose. Your company needs to be registered with each insurance as a group and a contract. Then once the Med Director is credentialed and approved with each payer, you need to associate them with the group and contract. Good luck!

    • @adisaomowunmi6388
      @adisaomowunmi6388 4 місяці тому

      @@NavigtingtheBusinessofMedicine Hi, have been watching your videos on youtube and im trying now to get a job as a credentialing specialist and i feel i need help. so please i need to be connected with you.