January 2022 

Requirements for Timely Provider Credentialing

Did you know?   Minnesota passed credentialing legislation that became effective 1/1/2022.   This legislation requires that the credentialing process with Minnesota payers be completed within 45 days of a clean application.

Revenue Cycle Housekeeping Tips for the Beginning of the Year:

• Provider Directory information should be reviewed for each of your contracted payers. Review locations, providers-including credentials, specialties, addresses, phone numbers, clinic hours, services, and status of accepting new patients.

• Verify insurance coverage. Plans often change at the first of the year.

• Verify eligibility and benefit coverage for patients.

• Know which procedures will require prior authorization. The mandated list seems to grow daily.

• Ensure you have a strong policy to collect co-pays and deductibles prior to, or at the time of service. Make sure you staff knows how to collect co-pays and outstanding balances at patient responsibility at the time of service.