In this episode, Katia asks Danielle about the process of switching your group practice credentialing over to a solo practice. Danielle answers questions about what you need before switching over your credentialing, how to update the insurance companies with your new practice information, and some pro-tips on how to streamline the process.
Visit our Facebook Page for show notes on this episode.
Out of Network Billing TipsJuly 9, 2018 - 7:00 amHere are some tips to ease out of network billing confusion: What/Who is Out Of Network? Clinicians who have not signed a contract with an insurance company and do not have to abide by a contracted rate. Can still be subject to insurance audits for medical necessity and are still considered a HIPAA-covered entity. […]
6 Tips to Get Through a Care Review With an Insurance CompanyJune 26, 2018 - 7:00 amYou go to check your voicemail after a long day of seeing clients and you hear the message you’ve been dreading. It’s a representative from an insurance company wanting to do a care review on one of your clients and they’ve asked you to call them back. AHHHHH—but wait! Don’t panic. You’ll be just […]
Insurance and Expanding into a Group PracticeMay 21, 2018 - 5:00 amFirst of all—congratulations! If you are reading this post, that means you are at least thinking about expanding your practice and forming a group, which hopefully means you have a successful group practice or maybe just big dreams! For the sake of this blog post, I am going to assume that you are in a […]
What Clinicians Need to Know About the Interactive Complexity CPT Code (90785)May 7, 2018 - 10:25 am
Episode 17 New Year – Best Practices 
Question. Can I be part of the group practice at the same time that I am filling out forms that sayI am switching from group to independent. This is where my anxiety comes in.
Hmmm–if it’s ‘switching’ then you might be actually switching your credentialing vs. adding a new practice to your existing credentialing. I’d have to to see the forms to know for sure though.
THANK YOU so much for these amazing podcasts! They are relieving much of my anxiety as I am in the process of moving from a group practice to solo! My question is similar to the one above, how early do I need to start this process to make a smooth transaction from group to solo, as I have clients that want to follow me as I switch practices? Do I wait until my last day at the group practice or do I start the process earlier so my clients will already have insurance coverage when they arrive at my practice? I don’t want to mess anything up by jumping too early. My last day will be mid Jan. at the group practice and I want to hit the ground running as quickly as I can in my practice so there will be minimal interruption with my clients who follow me.
Thank you again for your time and this awesome advice!
Hi! Sorry I am just getting around to answering comments. If your group is ok with it, I would start the process sooner rather than later!
Hello Danielle,
Does this podcast on switching credentials apply to MD’s as well ?? Are there any extra steps involved if its MD
I’m not too familiar with MD contracting. If the MD is contracted under a hospital or clinic–that would be a facility contract and they are different than private practice ones.
Hello Danielle,
How long would you say it would take to switch credentials from a group practice to solo practice? Do you think it would be possible to continue to work at the group practice while the process is underway? With the declaration of an effective date be an option? Or is there too much room for error with something like this? Wondering if it’s best to just take a leave of absence while the process is playing out. But I would not want to deny any patients. I’m referring to a chiropractic practice.
Hi Joe,
It really depends on how quickly you submit your new information and all of that. When I did it, some panels too 2 weeks while others took 5 months. Some panels backdate effective dates while others do not. If you have individual contracts, you’d just need to switch your EIN and address. You could always see private pay and out of network until you get things sorted out.
In the age of telehealth could you use a PO box?
You can use a PO Box for your billing address (W-9) but no panel will allow a service address to be a PO Box.
Some solutions are to:
-Get a virtual address (Regus etc. offers these)
-Ask a colleague to use their address
-Ask the insurance company if you can put an address down as virtual/telehealth only and if you do, will that address be on the public provider directory.
Hope this helps!
Hello!
I am currently credentialed with a group. I would like to keep working with the group and ADD my new private practice. Would it be the same process if I want to ADD (not switch) my new practice address under a new TIN number?
It would as you cannot add a new private practice to a group contract. You would need contracts for your nrew group. I speak more in-depth about this in my webinar:https://webinars.beyourownbiller.com/offers/VJ5iodoJ/checkout