Simplify Credentialing with Legacy's experts

Q: How long does Medicare credentialing take?

Initial Enrollment: This process can take 60 to 120 days, including the submission of CMS-855 forms and necessary documentation. This assumes the group is already enrolled and we are adding a new provider. Revalidation: Typically required every three years and takes 60 to 90 days for processing.

Q: How does the application process work with payors?

Each insurance company follows its own procedures. Some use online portals like Availity, while others require paper applications. For Medicare enrollment, the application is done through PECOS, a key platform for healthcare provider credentialing.

Q: What are the pricing models for credentialing services?

We offer flexible pricing options: Flat Fee: A set fee based on provider type and payer complexity. Per Provider Fee: Billed individually for each provider requiring medical credentialing services. Hourly Rate: Based on the time spent on the credentialing and enrollment solutions. Additional fees may apply for expedited services or updates.

Q: Can my team assist in the credentialing process to save costs?

Yes, your team can assist by gathering necessary documents, completing application forms, and following up with payers. This can reduce costs while ensuring accurate and timely submissions for medical billing and credentialing services.

Q: What types of contracts do healthcare providers typically enter with payors?

Common reimbursement models include: Fee-for-Service (FFS): Providers are paid for each service rendered. Capitation: A fixed monthly payment per patient. Pay-for-Performance (P4P): Reimbursement is tied to quality metrics. Bundled Payments: A single payment for all services related to a specific procedure.

Q: What should we do if a payer's network is "closed"?

Understand the reason: This could be due to capacity limits or network management strategies. Explore alternatives: Consider contracting with other insurers or different plans from the same payer. Follow up: Networks may open over time, so stay in touch with the payer for future provider credentialing services opportunities.

At Legacy Consulting Services, we know that provider enrollment and credentialing shouldn't be a roadblock to patient care or revenue flow. Yet, many practices and hospitals struggle with long processing times, rejected applications, and back-and-forth headaches with insurance payors.

The result? Delayed billing, lost revenue, and frustrated providers. We do things differently.

With Legacy's provider enrollment or credentialing services, you can ensure timely enrollment and avoid these setbacks. Get paid FASTER!

Why Legacy's Credentialing Services Are Essential

Credentialing is a complex process with strict deadlines and numerous application requirements. Legacy Consulting specializes in simplifying this process, allowing you to focus on what matters most: delivering exceptional patient care.

From enrolling new facilities and providers to managing ongoing credentialing, our Credentialing experts handle every detail.

Here's What Sets Legacy Apart:

Unlike other credentialing services that simply submit paperwork and wait, we take a proactive, hands-on approach to ensure your providers are credentialed and enrolled as quickly and smoothly as possible.

- Speedy & Accurate Enrollment: We understand the attention to detail required for the credentialing process, ensuring faster approvals from insurers and minimizing delays.

- Experienced & Knowledgeable Team: Our experts are always up-to-date on the latest payer requirements and healthcare credentialing regulations.

- Comprehensive Solutions: From CAQH registration to re-credentialing, we offer complete end-to-end credentialing services for your practice and providers. We also can streamline the approval process of Privileging & Hospital Appointments.

Read a testimonial from one or more of our clients about how we expedited the credentialing process.

What is The Real Cost of Credentialing Delays?

Many providers don't realize the true financial impact of delayed credentialing. Every day your provider isn't credentialed means lost revenue from unbilled claims..

Example: If a provider generates an average of $5,000 per day in billable services, a 30-day delay could mean a $150,000 loss in potential revenue. Can your practice afford to wait? Most payors don't give retroactive effective dates.

How Long Does the Credentialing Process Take?

Credentialing typically takes between 60 and 120 days, depending on factors such as payer backlog, application completeness, and provider qualifications.

Tip: Start the credentialing process early to avoid delays in accepting new patients and getting reimbursed for services.

Requirements for Provider Enrollment

Specific requirements must be met for each provider and payer to ensure smooth and timely enrollment.

Our Contracting and Credentialing Services Include:

New Provider Enrollment: We manage the entire credentialing process for new providers joining your practice, ensuring a smooth and efficient transition.

Payor Contracting: Whether adding a new insurance carrier or updating an existing plan, we handle the paperwork and follow-ups to maintain your practice's contract status.

Ongoing Re-Credentialing: We ensure that your practice and providers stay compliant with timely revalidation for Medicare, Medicaid, and private or commercial insurers, preventing service interruptions.

The Legacy Advantage: Why Outsource Your Credentialing?

Legacy's credentialing services positively impact your practice in the following ways:

🚀 Faster Provider Onboarding: Your new providers can start seeing patients and billing claims sooner, reducing revenue loss due to credentialing delays.

💰 Improved Cash Flow: With quicker enrollments, your practice can bill payors faster, preventing cash flow disruptions and ensuring steady revenue.

⏳ Less Administrative Burden: We take credentialing off your plate, allowing your staff to focus on patient care and operations rather than paperwork.

📈 Stronger Payor Relationships: Our team's expertise in working with insurance companies ensures smoother interactions and better outcomes for your practice. off your plate, allowing your staff to focus on patient care and operations rather than paperwork.

Clear & Transparent Pricing

We offer flexible pricing models to fit your practice's needs:

Flat Fee: For straightforward credentialing services.

Per Provider: This is typically for practices with multiple providers requiring individual credentialing.

Hourly Rate: For complex credentialing needs, such as special payor enrollment or intricate situations.

Frequently Asked Questions

How long does the credentialing or provider enrollment process take for a new provider?

Depending on the payor, the provider enrollment process typically takes 60 to 120 days. This timeline may vary based on factors such as:

payor's backlog of applications,
whether the provider is newly out of school,
whether the provider has been in-network with this payor previously in the same state,
verification requirements,
CAQH updates are needed, and many other reasons.

How long does Medicare credentialing take?

What factors affect the timeline for credentialing services?

Several factors can impact the credentialing timeline, including:

Application Completeness: Ensuring all necessary documentation is included can speed up the process.
Verification Process: Delays may occur if there are issues with verifying credentials or third-party confirmations.
Payer Requirements: Different payers have varying requirements, which may impact overall timelines.

How does the application process work with payors?

What are the pricing models for credentialing services?

Can my team assist in the credentialing process to save costs?

What types of contracts do healthcare providers typically enter with payors?

What should we do if a payer's network is "closed"?

What Our Customers Have to Say

I am pleased to provide a follow-up review for Legacy Consulting, whose outstanding credentialing services have significantly benefited our practice. We used them several years ago and chose to engage them again to expedite the credentialing process for two new providers joining our team. Donna and the entire team at Legacy Consulting went above and beyond to ensure that all major payors' provider numbers were secured promptly, allowing our new physicians to start seeing patients within a remarkably short timeframe from contract signing. Their efficiency, attention to detail, and commitment to excellence were truly impressive. Based on our experience, we have no hesitation in recommending Legacy Consulting for any credentialing needs. Their professionalism, expertise, and proactive approach have made them a valuable partner for our practice, and we look forward to continuing our relationship with them in the future.

Jimmy Norman

Administrator, Surgical Clinic PC

Legacy Consulting has been a savior for my practice. We have now been with Legacy Consulting for almost 6 years and can't imagine them not being part of our practice. Donna and her team have transformed many areas of our business including billing, collections, compliance, staffing, budgeting, and so much more! Everyone we've worked with at Legacy has been polite, efficient, and an expert in their field... and such a pleasure to work with!!! I wholeheartedly recommend Legacy Consulting to aid with your business management needs and medical billing.

Jeff Jones

Jones Physical Therapy

Navigating the complex world of Medicaid credentialing can be a daunting task, but Legacy Consulting prove to be an invaluable asset throughout the process. Their team of experts provide clear guidance, timely assistance, and unwavering support, making an otherwise overwhelming experience significantly smoother. Here's what stands out: Expertise and Efficiency: Legacy Consulting's deep understanding of the credentialing landscape has been evident from the start. They streamline the process, ensuring timely submissions and addressing potential roadblocks proactively. Communication and Support: The team maintains open communication throughout the journey, keeping us informed about progress, deadlines, and any required documentation. Their responsiveness and willingness to address concerns are truly commendable. Attention to Detail: Legacy Consulting meticulously reviews every detail of our application, ensuring accuracy and compliance with stringent regulations. Their commitment to precision minimizes the risk of delays or rejections. While the credentialing process can be lengthy and frustrating, Legacy Consulting's expertise and dedication significantly alleviates the stress and uncertainty. Here at Cornerstone Caregiving we wholeheartedly recommend their services to any healthcare provider seeking a seamless and efficient credentialing experience.

Shayna Cherry

As a healthcare facility looking to streamline our insurance credentialing process, I turned to Legacy Consulting and couldn't be more satisfied with the results. From the very beginning, their team was incredibly professional and knowledgeable about the complexities of insurance contracts, including Medicare, Medicaid, and commercial insurers. They learned the specific insurances for my state and developed relationships with those insurance company representatives. Throughout the process, I was kept updated regularly. I didn't have to chase them down for information, which made the whole experience less stressful. Legacy provides personalized service. They took the time to understand my specific needs and tailor their approach to my situation. They didn't just offer a one-size-fits-all service. I highly recommend Legacy Consulting for any insurance credentialing needs. They have assisted with professional credentialing and other aspects of the revenue cycle. Their knowledge is vast and their willingness to see your company succeed is evident. I highly recommend Legacy Consulting.

Susan Shreve

We searched extensively for the right credentialing and billing partner for our telepsychiatry startup, ultimately deciding that Legacy was the most knowledgeable and cost efficient option for us and that decision has been rewarded on an almost daily basis. Donna and her team are experts in the credentialing and contracting space, able to not only get our providers in network with major insurance payers as well as FHCPs but have become our go-to source of guidance as we negotiate with the payers and plan the optimal way to structure our organization to make it as accessible to those who are paying with insurance as possible.

They are professional, results oriented, swift and personable. I would recommend the Legacy team to anyone who is looking to initiate or optimize their insurance credentialing, contracting or billing operation!

Reed Semcken

Intern, Cerebral Medical Group

We have used Legacy Consulting for several credentialing projects. They have been extremely knowledgeable, thorough and timely in their responses. They have taken a challenging process and made it streamlined and easy for me as an administrator. We highly recommend them!

Amy Fisher

Administrator, Lee Obstetrics and Gynecology

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Let's Get You Credentialed - The Right Way, The First Time!

Stop losing valuable time and revenue - Partner with Legacy Consulting Services and experience a faster, smoother provider enrollment process.

Contact us for a free consultation to learn how we can simplify your practice's credentialing process and improve your cash flow or even assist with medical billing challenges.

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