Palmetto GBA Selected as Medicare Administrator for Jurisdiction J

The federal Centers for Medicare & Medicaid Services (CMS) has selected Palmetto GBA as the Medicare Administrative Contractor for Jurisdiction J. This jurisdiction, covering Alabama, Georgia, and Tennessee represents 7% of the national Part A/Part B claim-volume workload.

This change is having a dramatic impact on anesthesia practices across this 3 state regions. These practices have worked with Cahaba GBA for years, and the migration process will take some time.

What Your Anesthesia Practice Needs to Know about Transitioning to Palmetto GBA

Medical Business Management has thoroughly analyzed this process, and here are the key things that your practice needs to know about the transition from Cahaba GBA to Palmetto GBA. We have worked with Palmetto GBA for years supporting clients in other regions, and we believe that this change will be beneficial for anesthesia practices and CRNAs in Alabama, Tennessee, and Georgia, but the transition will be challenging and there are a number of pitfalls to avoid.

Claims Processing

All internal processing for Medicare claims has changed. Pay close attention to revised procedures for Palmetto GBA.

Online Tools

Palmetto GBA has a number of online tools that were not available through Cahaba GBA. Medical Business Management has used these online tools and features have enabled Medical Business Management to better serve our clients with coding and claims processing.

Is Palmetto Anti-CRNA?

Some CRNAs are concerned because the Palmetto’s manager is an anesthesiologist. It is possible that CRNAs will get cut out of some things. The best thing that CRNAs can do to manage the transition is to ensure accurate coding and compliance. Contact MBM today to find out more about how these changes might affect CRNAs.

Faster Time Frames

Credentialing takes an average of 60 days, but Cahaba GBA has been taking 120 days. They had a lot of employee turnover and they are trying to catch up using temporary employees. This strategy has not been effective to this point, but anesthesiologists should see an immediate improvement with the transition to Palmetto GBA.

Resources for the 3 Month Transition Period

Part B transition started on December 1, 2017, and the process will be complete on December 26, 2018. Our goal is to manage the transition process for our clients so that they don’t have to re-credential. This is a critical time for anesthesia practices and CRNAs. Do you have questions about the transition process? Contact us today to find out what you need to do to ensure a smooth process.

Essential Steps for Success with Provider Credentialing

medical credentialing company

Provider credentialing is a complex, yet critical, process for virtually any healthcare provider. Without credentialing, reimbursement for providers can be delayed or denied – meaning that a practice’s revenue cycle depends on accurate and correct provider credentialing.

Credentialing involves a verification of a provider’s experience, expertise, and ability to provide meaningful medical care for his or her patients. This is especially important for enrolling in health care plans as a participating provider.

To ensure that your providers are successful credentialed, so that your revenue cycle continues on unfettered and unchallenged, here are essential steps for successful credentialing, courtesy of Medical Business Management.

Begin the Process Early

Provider credentialing isn’t something that can be successfully started at a moment’s notice. It takes careful planning – sometimes months in advance – whenever a new associate or provider joins the practice.

It is best to begin the credentialing process as soon as an offer is extended to a new provider. It can take several weeks for credentialing paperwork to be processed, which means anyone who begins a new term of employment with a practice without having the advance work done may not be able to bill for their services!

Many problems in the initial phases of credentialing can be solved by getting an early start on the process. If your practice is already behind, getting help with provide credentialing can be a way to catch up and get ahead of the game eventually.

Create an Efficient Process

Efficiency in the process can save valuable time and ensure your revenue cycle goes unhindered. This is not just for initial credentialing; it’s also for re-credentialing that is seemingly always pending, and for any annual updates that are often required.

Some practices create intricate spreadsheets that track hospitals, payers, and other third parties that need updates and have specific requirements for submissions (along with deadlines). Others use software that essentially performs some of these key tracking and recording functions (but still require extensive staff time). There is also the option of outsourcing provider credentialing to providers who can create a process for you and execute it on your behalf.

No matter what option you pursue, you need a process that you can easily replicate whenever a new addition joins your practice – and to handle re-credentialing on an annual basis.

Develop a Habit for Thoroughness

Being thorough is the key factor behind successful credentialing. When filling out forms for any credentialing database, it’s important to not leave anything blank, and to supply accurate information in full. All requested documentation should be provided. Anything left out of the process can cost you weeks in lost productivity as you have to catch up. It’s best to be completely thorough from the beginning and adopt a detail-oriented mindset for credentialing.

Outsource Provider Credentialing

The go-top method for ensuring successful provider credentialing today is to outsource it to specialists who have years of expertise and training in credentialing for healthcare providers.

Doing so will free up manpower, time, and resources. It will also ensure that your credentialing is in the hands of professionals who know the ins and outs of successful credentialing and can better ensure a smooth, efficient, accurate process that doesn’t negatively impact your revenue cycle.

Contact Medical Business Management for more information on our provider credentialing services that can be a powerful boon to your practice’s operations.

Palmetto GBA Selected as Medicare Administrator for Jurisdiction J

The federal Centers for Medicare & Medicaid Services (CMS) has selected Palmetto GBA as the Medicare Administrative Contractor for Jurisdiction J. This jurisdiction, covering Alabama, Georgia, and Tennessee represents 7% of the national Part A/Part B claim-volume workload. This change is having a dramatic impact on anesthesia practices across this 3 state regions. These practices […]

Essential Steps for Success with Provider Credentialing

Provider credentialing is a complex, yet critical, process for virtually any healthcare provider. Without credentialing, reimbursement for providers can be delayed or denied – meaning that a practice’s revenue cycle depends on accurate and correct provider credentialing. Credentialing involves a verification of a provider’s experience, expertise, and ability to provide meaningful medical care for his […]