Provider Enrollment for Start Ups: Single Providers and Small Practices

Starting your own private practice? Confused about credentialing requirements? Running out of time and patience? You are one click away from a tasy solution.

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Congratulations on Your New Private Practice

We're excited for you! Here are a few required steps and documents you will need before begin any credentialing and enrollment project.

Your Business Entity

Even as a sole practitioner, you will want to be contracted with health plans as a business entity such as an LLC, PLLC or similar. This is an important first step.

Your Tax ID

With your business officially established, it's time to get your Tax ID from the IRS. The Tax ID will be a critical piece of information for your practice's billing.

Type 2 NPI

As a healthcare provider, you probably already have a Type 1 NPI. If you don't we can help with that, too! A Type 2 NPI is the same thing, but it is specific to your business.

Banking Information

Another important step is establishing a business bank account for your practice. This is a critical task to be completed before you begin provider enrollment.

Certificate of Insurance

Your certificate of insurance (COI) is your official, written verification of insurance coverage. This another minimum requirement to begin enrollments.

CAQH

CAQH is an online repository of provider data including demographic, education and training, work history and more for insurance companies to access.

Working with pie is a Piece of Cake!

Here's how we get you enrolled.

Initial Consultation

In this risk-free, no-cost consultation, we learn about you, your specialty, your practice and your goals. We'll talk about your business structure, timing and try to understand what your priorities are. If there's a fit, we can get started right away. • Basic Q&A • Review our process and approach • Sign a services agreement • Set-up payments

Onboarding

Once you've decided to work with pie, we'll send you to our our onboarding application. During onboarding we don't bombard you with a thousand fields to fill-in. We ask you one question at a time and ask you to provide the information we need to get your enrollments started. • Professional Licensure • Education and Work History • Contact Information • Required documents • CAQH, NPPES and other Login Info

Payor Mix & Planning

Now that we have your information, we start making real progress. Your documents and information will be reviewed by our experienced Credentialing Director, who will be contacting you directly to schedule a detailed planning session. Your Credentialing Director will help you identify the best Payors based on your geography and specialty. • Top 5 Payors in your state • All other available options • Type 2 NPI, CAQH maintenance (as necessary)

Enrollment, Follow Up & Appeals (if needed)

With your information received and Payors selected, it's time to submit your applications. • Pre-applications and Applications submitted • Bi-weekly* follow-up with Payors • Updates in custom web portal • Monthly update meetings & reports • One-time appeals for any possible rejections

Contracting & Celebrating

Talk about effective! Now, you have an effective date and a contract with your health plans. You can start seeing patients and submitting claims. • Begin preparation to work with billing companies • Expand your patient population • Have pie take care of your long-term maintenance needs

What insurances do you want to accept?

We'll help you find the perfect mix!

Get Started Now!

Schedule a free consultation to discuss your credentialing needs.

Schedule Your Free Consultation