Credentialing for Physician Assistants and Nurse Practitioners

Physician Assistants (PAs) and Nurse Practitioners (NPs) are found in every medical specialty and health care setting.  When you involve a PA or NP into your organization and utilize them effectively, the practice will service an increased number of patients. Additionally, you will reduce patient waiting time, increase patient satisfaction levels, and improve overall practice efficiency. All of this equals  increased revenue for the practice. Proper credentialing is an important and necessary requirement and essential for proper compliance.

Rules For PAs And NPs Vary By State

Medical board rules vary slightly from state to state, but for the most part, PAs and NPs can perform many tasks traditionally reserved for physicians. These services often include:

  • Physical exams
  • Patient histories
  • Health screenings and preventive care
  • Assisting with surgeries, ER, and long-term care
  • Issuing prescription orders
  • Chronic disease management
  • And much more…

Interesting statistics:

  • The typical PA brings in revenue of $231,000 with an average salary of $84,000
  • An average PA or NP can boost a practice’s bottom line by $30,000 or more
  • Training costs for PAs are one-fifth of an allopathic physician

How Long Does Credentialing Take?

Credentialing can take a long time. The most common credentialing pitfall is that the process is not started early enough.  Often, paperwork can be initiated up to 30 days before starting work and it is common for some hospitals and health systems to take up to 90 days for full credentialing.  PAs and NPs need to be organized and have copies of their educational background and certifications handy. Forms and paperwork must be completed in a timely manner to expedite the process.

Practice managers and health care administrators need to be familiar with state regulations and licensing requirements. Regulations are different state by state, and payer by payer.  Some states require a certain percentage of charts to have a co-signature, while others have no such requirement. Some states limit the number of PAs or NPs that can work with a single physician, and others do not. All states require some level of documentation to be kept to show compliance with the rules.

PAs And NPs Help Workflow

Utilization of PAs and NPs is common across all medical specialties. Changes in medical resident workforce requirements as well as changing third party payer reimbursement models have encouraged the exploration of new ways of achieving high quality patient care across all specialties. In 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted limitations on total hours worked by residents in both inpatient and outpatient settings.  This mandate to limit work by training residents has created a need to fill patient care hours. PAs and NPs have no such work restrictions and since these new regulations took effect, have been utilized in greater numbers, especially in the hospital setting.

Large Teams Equals More Struggles with Compliance

By increasing the care team and number of providers in an organization or practice, there becomes a higher risk of errors or outdated information being kept. When it comes to NP and PA Credentialing and enrollment, Eddy is here to help. Our suite of solutions offer an option that is ideal for your practice no matter how large or small. Our competitive pricing structure and superior  product offering, allows for us to manage entire institutions credentialing process and ensure all updated information is collected and monitored. Before taking on the task of Credentialing for NP or PA, contact Eddy today. We are here to help.

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