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The Private Medical Practice Academy
I discuss everything you always wanted and absolutely need to know about start, running and growing a private medical practice. I'll also talk about how to leverage your private practice by adding additional providers, satellite offices and ancillary services. And, vertically integrating other medical businesses like adding an ambulatory surgery center, imaging center, physical therapy and more. I will be sharing my 30+ years of experience as a physician and entrepreneur. After being an employed physician, I started and managed my own private medical practice with 11 providers. I added multiple medical businesses: in-house laboratory services, ambulatory surgery center, physical therapy, imaging center, anesthesia practice management company. I developed joint ventures between physicians and hospitals as well as between physicians and complimentary providers. In addition, I have extensive experience in developing and leasing real estate pertaining to medical services. Be sure to sign up for my newsletter and I'll keep you up to date on everything about starting, running and growing your practice and more.https://www.thepracticebuildingmd.com/podcast-optin-email-newsletter-1
The Private Medical Practice Academy
Episode 12: Everything CAQH (that you need to know)
What is CAQH?
CAQH (Council for Affordable Quality Healthcare) is nothing more than a giant database of credentialing information. Insurance companies and other credentialing entities pay to access the information but is free for YOU, the provider.
What does CAQH do and why is it important to you?
- If you want to be credentialed by an insurance company, you have to send them a whole bunch of documentation--licenses, proof of malpractice, your DEA/state CDS and more. And when each document expires, you have to provided updated documents.
- Using CAQH allows you to upload the documents in one central location and have them disseminated to insurance companies rather than having to send the documents to each individual insurance company. It will save you a huge amount of time.
- CAQH does not submit application to the insurance companies or complete the credentialing process for you.
How to register with CAQH?
- Have all of your documents ready for uploading. Make sure your CV is updated. You'll need your license, DEA/CDS, proof of malpractice, CV, W9, proof of board certification, diplomas, and proof of hospital privileges (if applicable.)
- Have three professional references
- If you are starting a practice you'll also need information about the new entity: the legal entity info, tax id #, address (including payment and correspondence if they're different), billing company info if you are outsourcing, credentialing contact, billing contact, hours of operation, phone/fax, group NPI (if you have multiple providers) and your NPI.
- Once you have everything ready, go to https://proview.caqh.org/pr/registration/selfregistration
- At the end of your application you need to grant access to the payers. In order to do this you MUST submit a signed ATTESTATION form provided by CAQH.
- Once you have signed and dated the attestation, make sure to upload the document (or nothing will happen).
- Save your CAQH ID#, user id and password in a safe place. Check CAQH at least every 60 days to make sure there's nothing that needs attention.
Can you do this yourself? Yes, absolutely. The majority of the time and effort comes from gathering all of the information. You will need to do this part regardles
Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com
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Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.
Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.
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