Ingrid and Carl’s Story: Ensuring Your Insurance Credentials

When Ingrid and Carl bought their practice seven years ago, they weren’t too concerned with medical credentialing. As gastroenterologists, most of their patients were referrals from primary physicians. Even if Ingrid and Carl weren’t enrolled in an insurance company’s preferred provider network, most of these patients had “out of network benefits,” and would pay out of pocket and file for reimbursement later. However, in just the past few months, they’ve lost a growing number of potential patients to competing practices because they didn’t take their insurance. With a busy practice and two kids at home, Ingrid and Carl just didn’t have the bandwidth for filling out network enrollment applications, and all the time-consuming, yet necessary, follow-up.

Medical credentialing has become more important as health insurance plans have become broader in regards to the scope of services they cover. That’s why every one of NCG’s consultants—including our gastroenterology consultants—is now a specialist in medical credentialing. Our longstanding relationships with all of the major healthcare insurance networks allowed us to not only take the burden of credentialing off of Ingrid and Carl’s plate, we also got their applications expedited. Instead of taking between three and four months to submit the necessary paperwork, tender supplementary documentation, and correspond with insurance companies’ credentialing departments, Ingrid and Carl’s credentials were completed in sometimes as little as four weeks. Ingrid and Carl’s practice is now growing, and our medical billing specialists at NCG are making sure they are receiving the maximum compensation they’re entitled to on their new insurance claims.