Healthcare Credentialing 101

HealthShield Credentialing

The healthcare profession has evolved at a rate unlike any time in modern history. Burnout reported since 2020 has led to one in five workers exiting the profession all together, with another 19% considering leaving.1 As staffing shortages have become more prevalent, hospitals have turned to paying higher rates for temporary staff, such as travel and contract workers, who must have the right credentials in place.

Credentialing healthcare workers can be time consuming and costly for temporary workers. The amount of time, expertise, and attention to detail necessary to obtain credentials can deter professionals from changing jobs or doing contract work.

With healthcare staffing demand far outpacing supply throughout the country, the opportunity is ripe for workers to take advantage of higher salaries, more fulfilling jobs, improved work-life balance, and travel to different areas not previously possible. Organized credentialing information, ready to send at a moment’s notice, is essential for these traveling workers.

HealthShield offers an easy solution to keep all your records in one place, available on-demand, to save time, money and frustration associated with the credentialing process.

CREDENTIALING 101

Credentialing is the process of verifying that a provider is qualified to provide medical services and that they have the capabilities and expertise to perform within his or her scope of practice. It is required by law and ensures quality and safety for patients. Done properly, hospital credentialing process also protects providers and hospitals.2

Documentation required during credentialing includes:

  • State License
  • National License
  • Board qualifications/certification status
  • Surgical Logs (usually two years’ worth)
  • Malpractice insurance claim reports (10 years’ worth)
  • Work History
  • Updated curriculum vitae
  • Certifications (ACLS, BLS, PALS, etc.)
  • DEA certificate
  • NPI Number
  • Immunization Records
  • Educational History
  • School Diplomas
  • Professional References
  • Driver’s License
  • Social Security Card
  • Marriage License
  • Color Photo
  • Background Check

Key mistakes in the credentialing process include incomplete, missing, or partial information, misspelled names, incorrect NPI numbers, and outdated or expired supporting documentation. This can create a back-and-forth scenario with the credentialing specialists and provider that can be time-consuming and frustrating.

Once all the documentation is received it must be verified. Some hospitals have in-house personnel while others use staffing or credentialing agencies. The average cost to credential a provider is $100-400 per job, though this varies across credentialing service agencies.  Costs for re-credentialing are approximately the same. Most insurances and facilities require re-credentialing to occur on a two-year cycle, although some payers or facilities may extend that by a year.3

Following the verification process, most hospitals require privileging requests. This can be an issue when many credentialing committees only meet monthly or bi-weekly to review and sign off on granting privileges to a provider.

Under the most efficient circumstances, a provider can be credentialed to work at a hospital or credentialed and approved to be in-network for a health insurance company in 30 days. More often, this process takes 60 to 90 days. On occasion, especially with insurance companies, it can take six months or more.4

HealthShield Credentialing

Despite the hassles and headaches of credentialing, it is important; emotionally and financially, to obtain the jobs and salaries that fit your life. HealthShield can save you time and help you keep your information and documents ready and up to date on a continuous basis. Your information will be available and encrypted on all your devices the moment you need it.

HealthShield is revolutionizing the collection and dissemination of professional information with the creation a user-friendly interface, automated reminders, and the ability to share your information securely with your next employer at the click of a button.  Go to https://healthshieldcredentialing.com/ and become a member to see how HealthShield can ensure you are credentialed for your next job with less hassle and in less time.

STEPS TO FOLLOW TO BUILD A 1099 BUSINESS:

  • Protect yourself and your assets by performing your contract work under the umbrella of a business entity. Think about what you’d like your proposed business to be named!
    • Visit your Secretary of State website to see if your chosen name is available
    • Check with your state’s Board of Nursing for state specific requirements
  • File applicable business set-up paperwork
  • The S-Corp Edge: How you structure your 1099 CRNA business will have far-reaching consequences, whether it is a sole proprietorship, a limited liability corporation (LLC), or an S corporation (S-corp). 
    An S-corp may offer several advantages over other business structures when it comes to taxation. In this structure, a business owner is called a shareholder, and the business owner is recognized by the IRS as an employee of the business. What this means is that the business owner must pay themselves a salary through the corporation. The S-corp pays their payroll taxes, which can in turn be deducted as a business expense. Income tax is paid through its owners’ tax returns based on their percentage of ownership. Moreover, any remaining profits have a lower tax rate than regular income. An S-corp may also allow 1099 CRNAs to avoid a higher tax level that other self-employed contractors pay for Medicare and Social Security.
          A CRNA may structure their company as an S-corp serving as the sole owner, with their business income, tax deductions, and losses passing through to the owner, as opposed to being taxed at a corporate level – a potentially smart move for maximizing financial security in the future.
    • Register for an EIN
  • Open a business checking account and credit card
  • Keep track of all your business expenses as these could save you money come tax time!
    • Have an envelope for receipts or a folder on your computer where you scan these into
  • Be sure not to co-mingle your business and personal finances!
  • Remember, as a freelance CRNA, if you don’t work, you don’t get paid!
    • Do you have at least six months savings should your contract abruptly stop?
  • Think about replacing your current benefits
    • Health Insurance
    • Health Savings Account/Dependent Savings Account
    • Retirement Savings Account
    • Life Insurance
    • Disability Insurance
  • Procure malpractice insurance
  • Look for jobs!
  • Apply for state licenses where you want to work
    • Each state needs a different CRNA license (and RN if they are not a compact state). Keep this in mind as some BONs can take 3-6 months to license a provider.
  • Have an employment attorney review your contract
  • Have your contract written to your business and deposit all earnings into your business checking
  • Keep A Schedule
  • As a W-2 employee, your taxable income and amounts taken out for taxes appeared on your W-2 form at the end of every year, without you having to calculate them. But when a firm pays more than $600 for services from an independent contractor, that income must be reported to the IRS.
    What many 1099 CRNAs don’t realize is that they must pay taxes on their income as they earn it. Paying your quarterly estimated income taxes will be a new part of running your business successfully. 
          It doesn’t sound so difficult—keeping track of paying estimated income tax only happens four times a year. But the reality is a late payment can result in penalties and fines from the IRS. Keeping a schedule to help you stay on top of your quarterly estimated tax payments, and paying adequately to avoid underpayment, is imperative in avoiding penalties in the future. Not to mention providing peace of mind!
  • Make sure you have a trusted team of accounting and/or financial professionals who have experience with freelance CRNAs to guide you through this process!
  • CPAs
  • Financial Planners
  • Bookkeepers
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