Credentialed as PMR pain instead of Anesthesia Pain

[Painologist]

I’m in the process of starting a new solo practice next month. Some of my insurance commercial contracts are starting to come through just on time (started the process in January). I noticed the credentialing company I hired labeled me as PMR/Pain instead of Anesthesiology/Pain. I mentioned this to them and they said it will not make a difference and billing should be fine. Should I have them update this or just roll with it? I don't want to put any of my contracts in jeopardy...

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[Agast]

I’m in the process of starting a new solo practice next month. Some of my insurance commercial contracts are starting to come through just on time (started the process in January). I noticed the credentialing company I hired labeled me as PMR/Pain instead of Anesthesiology/Pain. I mentioned this to them and they said it will not make a difference and billing should be fine. Should I have them update this or just roll with it? I don't want to put any of my contracts in jeopardy...

What a lazy-ass credentialing company. You should insist on them changing it. They can’t guarantee it won’t bite you in the butt later.

 

[Painologist]

What a lazy-ass credentialing company. You should insist on them changing it. They can’t guarantee it won’t bite you in the butt later.

Changing it would not restart the credentialing process, correct?

 

[Agast]

Changing it would not restart the credentialing process, correct?

To be honest, it might. It depends on how much of a stickler the insurance companies are. But then imagine if they find out you’re not the specialty you claim to be - that would be a huge blow-up if they wanted to be jerks later. There’s probably something in the contracts you sign with them stating all the information you provide is correct. What if they start pulling back payments or something??

 

[Painologist]

To be honest, it might. It depends on how much of a stickler the insurance companies are. But then imagine if they find out you’re not the specialty you claim to be - that would be a huge blow-up if they wanted to be jerks later. There’s probably something in the contracts you sign with them stating all the information you provide is correct. What if they start pulling back payments or something??

Thanks, I’m considering all options. My credentialing company is claiming they credential all of their pain docs as PMR… I see where they’re coming from considering we bill the same codes

 

[mid|ine]

Also, I know our groups contract rates are lower for our PMR doc then myself, anesthesia

 

[Painologist]

Also, I know our groups contract rates are lower for our PMR doc then myself, anesthesia

Is it a significant difference? Or like 5%

 

[deleted472101]

Does that decrease you malpractice?

 

[mid|ine]

Depends on the payer. Our PMR doc is not interventional.
Some of our privates are 120-170% medicare. I think some of our PMR docs are < medicare.

 

[Doctodd]

i wouldnt mess with the process right now. You can and should try correcting it later after you are set up and running IF there are no pauses in your payments.

 

[Painologist]

Does that decrease you malpractice?

My malpractice is for Anesthesiology / Pain

i wouldnt mess with the process right now. You can and should try correcting it later after you are set up and running IF there are no pauses in your payments.

Appreciate this.