Here is a recent question we received about independent and group provider credentialing (enjoy!):
I currently work for a group practice and have several insurances that I accept through that group practice. I was wondering if it is possible to take those contracts or credentials and work privately. Also, how long will this process take? If I’m credentialed, can I just start up my own practice? In general, what is the difference between being credentialed and contracted? I just want to make sure I have my terminology correct. Can your company assist me with this? Thanks!
When someone works for a group practice, they are sometimes “independently credentialied,” and just connected with the company’s tax ID number (via a W9 form) and the company’s address. Changing the provider credentialing situation so that the provider can start billing from their own practice (and billing from their own office) involves contacting the insurance companies, submitting a new w9, and submitting a change of address form. It generally takes about 60 days for this change to take effect.
On the other hand, sometimes when a provider is credentialed, they are credentialed as a member of a group–specifically through their employer’s tax id and insurance contact. In this instance, the provider would need to begin their credentialing from square one. This takes on average about 120 days.
To answer your question about “Contracted vs Credentialed”, these terms are interchangeable as they mean the same thing.
We hope this answer helps! If you think we can be of any help in the future, reach us anytime directly at 1-855-4-THRIVE.
Anthony and Your Friends at Thriveworks