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No, these are very different despite being interchangeably used in healthcare.

Provider enrollment is the process of registering a healthcare provider with insurance payers so they are classified as "in-network" providers and are listed on the health plan's list of preferred providers. The process involves submitting an application and required documentation to the payer, to establish the provider's eligibility to participate in the payer's network.

Provider credentialing, is the next step after payer enrollment where the payer verifies the qualifications, experience, and competence of a healthcare provider before they are allowed to be admitted to their network.

The biggest source of confusion around provider enrollment is underestimating the length of time it takes to complete the process with each health plan.  Many assume it will be a quick and painless process, but it often involves a lot of paperwork, verification, and following through to completion.

The provider enrollment process can take anywhere from 30 to 180 days, depending on the payer and the completeness of your application. Here are the general steps involved:

1. Application Submission: Filling out and submitting the necessary forms and documentation
2. Review by Payer: The insurance company reviews your application and may request additional information.
3. Credentialing: Verification of the provider’s qualifications and background.
4. Contracting: If you are a new practice, you will also need to review and sign a contractual agreement agreeing to terms.
5. Approval: Once everything is in order, the payer will approve the enrollment, and you can start billing for services.

Each payer has its own timeline, so it’s crucial to start the process well in advance of when you plan to see patients.

Outsourcing provider enrollment can be a game-changer for practices that find the process too cumbersome or time consuming. Here are a few reasons to consider it:

1. Expertise: Enrollment specialists are well-versed in the intricacies of various payers and can navigate the process more efficiently.
2. Time-Saving: By delegating this task, your staff can focus on patient care and other critical activities.
3. Reduced Errors: Professionals are less likely to make mistakes that could delay the process.
4. Follow-ups: They handle all the necessary follow-ups, ensuring your applications are processed in a timely manner.

All these factors can lead to quicker enrollments and fewer headaches for your team.

When you add a new location, there are a few key steps to ensure your enrollment is updated:

1. Notify Payers: Inform all payers about the new location. Each payer will have its own process and forms for updating practice locations.
2. Credentialing: The new location may require re-credentialing or at least an update of your existing credentials.
3. Update NPI: Ensure your National Provider Identifier (NPI) is updated to reflect the new location.
4. Licenses and Permits: Make sure any new local or state licenses and permits required for the new location are obtained and provided to payers.
5. Coordinate with Staff: Ensure your billing and administrative staff are aware of the new procedures and any changes to payer policies.

Keeping all documentation organized and staying on top of these updates will ensure a smooth transition.

To enroll your new physician, these are just some of the documents you'll need to provide  to the provider enrollment specialist:

1. Curriculum Vitae (CV): A detailed overview of the physician's professional journey.
2. Medical Degree and Residency Training Certificates: Proof of educational qualifications.
3. State Medical License: Valid medical license for the state where the physician will practice.
4. Board Certification: Certifications from recognized medical boards
5. DEA Certificate: If the physician will be prescribing controlled substances.
6. Malpractice Insurance Coverage: Proof of current malpractice insurance.
7. Professional References: Contact information from colleagues or supervisors attesting to the provider's qualifications and competence.
8. Academic Records: Transcripts and diplomas from medical school and residency programs.
9. Personal Identification: Government-issued ID, usually a driver's license.
10. NPI Number: The National Provider Identifier for the provider.

Providing these documents will help ensure a smooth and efficient credentialing process.