, pub-6833881739459126, DIRECT, f08c47fec0942fa0 Icon

Registering & Contracting with Insurance Companies

by Britany
(Copperas Cove, TX, USA)

I am trying to get my own medical billing business started, mostly because I have a client already lined up. My question is, how do I go about getting registered or recognized or whatever with the different insurance companies?

The client I am trying to help is an orthotics/prosthetics provider, and has had trouble getting contracts with the insurance companies. Can you give some advice to the both of us?


The process you’re referring to is called credentialing - the process of applying to participate in or be contracted with an insurance carriers network. The application process can be pretty involved - especially if you have to go through the process with each individual carrier.

You can sign up individually with each insurance company. The forms or process is usually detailed on their website. Many allow the application process online or you can print the application out there. This can be a fairly time consuming process.

Not sure why your provider has had difficulty
getting contracted with the insurance companies other than the fact that the credentialing process can sometimes be intimidating and difficult to complete. And honestly I'm not familiar with the Orthotics specialty to know if there are caveats to getting credentialed. If the provider is not an MD or is a DME provider - that may cause some challenges.

There is a non profit organization called CAQH that's kind of a “one stop shop” for the application process. Many of the insurance carriers participate in it. Basically once you enroll with one insurance carrier the providers can participate in the CAQH Universal Provider Datasource. Then when you want to participate in another providers network, the insurance company can just access the providers info in the CAQH database.

Here’s more discussion on CAQH Credentialing.

Enrollment in Medicare requires completion of the 855I application available here - all 29 pages of it! Unfortunately anything having to do with Medicare usually involves lots of paperwork and waiting.

Medicare Enrollment - Completing the 855I on our Medical Billing Books page gives instructions on completing the Medicare process.

Hope this helps some. Hopefully others can comment (link below) also and offer more suggestions or opinions.



Comments for Registering & Contracting with Insurance Companies

Average Rating starstarstarstarstar

Click here to add your own comments

Mar 01, 2013
DME credentialing
by: Anonymous

Did you find a good process for applying for DME network participation. I am having a hard time with this as well.

Oct 08, 2011
Thank you

Just this one answer has given me tons of hope and help! thank you so much! And yes, she is a DME provider. Not sure why she has had trouble getting credentialed. I will be talking to her early this coming week, and I will be sure to follow up with you here. Again, thank you so very, very much for your help!

Click here to add your own comments

Join in and write your own page! It's easy to do. How? Simply click here to return to Your Questions.

Recent Articles

  1. Getting clients

    Mar 31, 18 09:47 AM

    Besides networking .. visiting their offices, how else can you attract their business? When you close the collections month, how do you bill the physicians?

    Read More

  2. Pricing for Claims Editing, Resolution, and Insurance Verification

    Mar 31, 18 09:36 AM

    I have a potential client that is requested claim scrubbing resolutions (only corrections on claims submission errors) and insurance verification on the

    Read More

  3. What to Do When a Provider Has a New Tax ID

    Mar 31, 18 09:28 AM

    The provider that I bill for just advised that he has a new tax ID. What is the process for this change? Would every insurance company need to be contacted?

    Read More

Disclaimer and Privacy provides this website as a service. Please read our full Disclaimer and Privacy Policy here.

Copyright 2022