Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

7 Tips for Successful Provider Enrollment

While no one may like the loads of paperwork required to enroll physicians and other healthcare providers with government and commercial payers, making sure that the required forms are submitted correctly and in a timely manner is essential for getting reimbursed for services provided.

Recently, Wisconsin Physicians Services (WPS) Medicare announced that in the final quarter of 2013, of the 24,000 enrollment applications they received, 42% of paper applications and 31% of internet-based PECOS applications were delayed because of inaccuracies or missing information.

WPS recommends the following to ensure applications can be processed expeditiously:

  1. Attach all required documentation.
  2. Complete all fields in all sections of forms.
  3. Have the proper person sign and date the form as required.
  4. For revalidations, be sure to pay the revalidation fee so that there is no disruption in Medicare reimbursement.

The CIPROMS enrollment and credentialing team, which takes care of this labor-intensive task for our clients, also has a few recommendations regarding the timely completion of payer enrollment applications.

  1. Since many applications and revalidations are time-sensitive, respond to all requests as quickly as possible.
  2. If you receive information about your enrollment directly from a payer and you do not handle these tasks yourself, forward those documents to CIPROMS or the entity responsible for your enrollments as soon as possible. Don’t assume that everyone involved is getting copies of the same information.
  3. Keep all contact information current. If you correspond directly with payers, make sure you update them of any changes. If you work with a third party, like CIPROMS, make sure you give them the updated information.

For more information about WPS Provider Enrollment, visit their Provider Enrollment web page.

Has handling this task for yourself or your practice become almost unbearable? Contact CIPROMS about options for letting us do your provider enrollment and credentialing for you. Download our Provider Enrollment and Credentialing fact sheet and/or contact us at cipromsmarketing@ciproms.com today.

— All rights reserved. For use or reprint in your blog, website, or publication, please contact us at cipromsmarketing@ciproms.com.


Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

© Copyright 2020