done for you services
Credentialing and Contracting Services
well, hello!
My team at The Reimbursement Dietitian and I are very excited to offer credentialing services for dietitians and CNSs. In order to determine if we are a good fit please answer the following questions and submit your application. You can expect to hear from someone on my team by email within 48 business hours, Monday – Friday with the next steps.
Before applying the following information is required:
The insurance companies require a PHYSICAL address to serve as your office space. While you may choose to offer hybrid services (telehealth and in-person) you must have a physical location. This location will be listed online in the insurance company directory.
Please don’t fill out an application for our services until you have determine your physical location.
Before starting the insurance credentialing process you MUST have your business entity determined. Your business entity is generally either a sole proprietor, LLC, PLLC or S-Corp. Unfortunately this is not something the team at The Reimbursement Dietitian can help you determine. You will want to meet with a tax professional to determine best entity for you given your state and personal situation. Certain states require dietitians to be a specific entity to participate with insurance.
credentialing and contracting
services
This service is for Registered Dietitians or Certified Nutrition Specialists who desire to get
credentialed with insurance but want a trusted agency to do it for them.
My team and I will do the following for you:
● Provide education about who the key insurance companies are in your state so
you can determine who you want to work with
● Answer any questions you have about the credentialing/contracting process
● Provide you with an estimated timeline so you know what to expect
● Apply for Private Payers and Medicare insurance contracts
● Provide consistent follow-ups & updates on applications
Investments:
Commercial contract single provider: $250
Medicare contract single provider: $300
Medicare Reassignment of Benefits: $200
We currently don’t offer contracting services for Medicaid products.
Most states have the following commercial insurance plans.
Aetna
Blue Cross Blue Shield or Anthem Blue Cross Blue Shield
Cigna
UnitedHealthcare
Medicare is a federal plan. Therefore, every state has Medicare coverage. However,
Medicare only covers beneficiaries with a diagnosis of diabetes, chronic kidney disease
(stage 3a, 3b, 4 & 5 non-dialysis)
FAQs
about using our credentialing and contracting services.
Q: By using your services, does the credentialing process go quicker?
Yes and No. It will generally go quicker because we know exactly how to complete and process your application. Many dietitians get ‘stuck’ on specific application questions or fill them out incorrectly, which adds more time to the actual process. However, the process will take the same time for someone who knows what they are doing. Meaning we are not able to do any ‘magic.’ We will complete your application as fast as possible, consistent with the terms associated with our agreement. However, using our services will not expedite the credentialing and contracting process.
Q. What things will you need from me to start the credentialing process?
First, you will need to fill out an application. YES. We will require a significant amount of information, including your practice location (YES! You need a physical address in the state you are credentialing in). Expect to provide information like your business entity (sole proprietor, LLC, or S-Corp), copies of your license (if applicable), certification information (if applicable), business checking account to set your electronic payments, NPI numbers, and login information; if you choose to credential with Medicare, we will NEED your social security number. So, while we will handle the credentialing process, you must provide us with the information needed to complete the job. If you need guidance on obtaining specific requirements, we will do our very best to help. So don’t stress at all about that. But we want to be transparent and say that we will need a lot of information from you—so much that it may even feel intrusive. Trust us, we just need it all for our job.
Q: What happens if I have not determined my business entity yet?
Before we begin credentialing, you must have determined your business structure (sole proprietor, LLC, or S-Corp). This is because we will need the tax ID associated with your business (a.k.a. your business’s EIN). If your EIN changes (because you change business structures), you must start the credentialing process from the beginning with your new EIN. The insurance companies see a ‘new’ EIN as a new business. So, unfortunately, you will need a whole new contract issued to the new EIN. Therefore, if you have not determined your legal business entity, we can’t work with you until you do.
Q. What about states where the insurance market is closed to dietitians, like Florida and Michigan? Can you get me into the network in those states?
We generally know the rules regarding credentialing dietitians in all states. So, before we start working with you in most scenarios, we already know which state insurance markets are temporarily or indefinitely closed. Once we receive your application and know what state you will be credentialing in, we will let you know our particular strategy for you. But the answer will always be NO for certain insurance products. There are specific markets that don’t directly credential dietitians or CNSs. And no matter who does the credentialing (YOU or us), no dietitians are getting in.
Q. What things will you need from me to start the credentialing process?
First, you will need to fill out an application. YES. We will require a significant amount of information, including your practice location (YES! You need a physical address in the state you are credentialing in). Expect to provide information like your business entity (sole proprietor, LLC, or S-Corp), copies of your license (if applicable), certification information (if applicable), business checking account to set your electronic payments, NPI numbers, and login information; if you choose to credential with Medicare, we will NEED your social security number. So, while we will handle the credentialing process, you must provide us with the information needed to complete the job. If you need guidance on obtaining specific requirements, we will do our very best to help. So don’t stress at all about that. But we want to be transparent and say that we will need a lot of information from you—so much that it may even feel intrusive. Trust us, we just need it all for our job.
Q. Do you credential Certified Nutrition Specialists (CNSs)?
Absolutely. But it will depend on what state you will be credentialed in. Certain states don’t allow CNSs to provide MNT, nor do they issue licensesto to CNSs. So, if you are in a state that will enable you to get credentialed with the insurance companies and have all the necessary information, we would love to help you get credentialed.
Q. How long will the credentialing process take?
This will depend on many things, but most importantly, on what state you are credentialing in. Based on our experience, ON AVERAGE, we know how long the process might take in each state. While some states go quicker, on average, you are looking at about 6 months from the time we submit your application to when we have your contract. Do some plans process your applications more quickly? Absolutely! However, given our 20+ years of credentialing dietitians, ‘stuff’ always seems to happen beyond our control, which adds time to the process. We will communicate regularly throughout the process, keeping you as informed as possible.
Q. Would the credentialing process go quicker if I worked for someone else, like a telehealth company or another private practice?
Yes and No. Sometimes, it does go slightly faster. But most of the time, it takes about the same time (around 6 months). And in some cases, it takes more time because our team needs to ‘untangle’ you from the other practice.
Q. Would the credentialing process go quicker if I worked for someone else, like a telehealth company or another private practice?
Absolutely. We can credential you under your practice without impacting the other practice’s ability to continue to bill for your services. This is because we are credentialing you under your business and tax ID, so your business is entirely separate from the one you are working for.
Now offering Credentialing & Contracting for dietitians and CNSs—more services coming soon!