Getting credentialed with Insurance Companies in Oregon for LMT's

11/4/2015

Steps for getting credentialed with insurance companies in Oregon:

1. Get your NPI (National Provider Identification) Number:https://nppes.cms.hhs.gov/NPPES/Welcome.do

2. Get a Tax ID (unless you plan to use your social security number):https://www.irs.gov/Businesses/Small-Businesses-&-Self-Employed/Apply-for-an-Employer-Identification-Number-%28EIN%29-Online

3. Fill out the Oregon Pracitioner Credentialing Application Important: Keep an unsigned and undated copy so that you can send it to multiple companieshttp://www.oregon.gov/oha/OHPR/ACPCI/pages/state_app.aspx

4. Fill out a W-9 and keep an unsigned/undated copyhttps://www.irs.gov/pub/irs-pdf/fw9.pdf

5. You will also need copies of your license and liability insurance

6. See the second sheet of this workbook for individual insurance company protocol-follow the procedure for each company you want to credential with

7. Review each companies fee schedules (usually sent to you with the contract during the credentialing process) and decide if you want to accept these

8. Sign and send back contract and any supporting documents to the respective insurance company.

Keep in mind that it can take 1-4 months to become credentialed with insurance companies
If you don't get an automatic confirmation from the insurance company regarding your application call or email to make sure they have received it 30 days after you send it in
Respond to all inquiries from the insurance company quickly and make sure you give them all of the documentation they request
Read fee schedules and contracts thoroughly
Keep great records of your communications with insurance companies and get reference numbers for each phone call