If you are planning to hire a new doctor or establish your own practice, it is crucial to initiate the credentialing process ahead of time to prevent potential issues. Neglecting the importance of medical credentialing services could lead to delayed cash flow, challenges in scheduling due to patient restrictions, and frequent communication with insurance providers.
This article aims to list 10 effective tips for successful medical staff credentialing. Before getting into that topic, let us first understand the significance of credentialing.
Provider credentialing is the process of confirming a physician’s attendance at a medical school and their possession of a state license. It also entails verifying their employment history and examining malpractice insurance carriers that are associated with them.
Additionally, credentialing requires conducting a background check on the provider's criminal and financial records, as well as a review of their social media background, which is becoming increasingly important. The references provided by the physician will also be checked. Since this is a complex procedure that often takes longer than anticipated, it is crucial to start preparing early. Here are ten helpful tips to ensure a successful provider credentialing process.
1. Connect with a medical staff credentialing partner
If you intend to delegate credentialing responsibilities, it is important to engage with a medical credentialing service such as ProLocums to effectively manage deadlines and expiration dates. By receiving timely reminders, you can guarantee that no one's credentials lapse, preventing any denials of reimbursements.
2. Make sure to allocate sufficient time for the credentialing procedure
It is recommended to budget around 150 days for the credentialing process, although it is expected to take approximately 90 days. It is important to be aware that each payer has its own timeline for credentialing. By assuming a longer time frame, you can ensure that you are prepared for the process, and if it takes less time, it will be a pleasant surprise.
3. Keep informed about the credentialing program offered by the Coalition for Affordable Quality Healthcare (CAQH)
Payers are widely embracing the Coalition for Affordable Quality Healthcare (CAQH) uniform credentialing program. Physicians who consistently update and verify their information through CAQH experience smoother and more effective credentialing and re-credentialing processes, making it highly beneficial to engage with this program.
4. Link the start date of a new provider to the submission of their credentialing forms
Some practices require credentialing paperwork to be submitted immediately after extending an employment offer, while others tie the starting date of a new physician to the submission of paperwork. For instance, you could set the starting date no earlier than 120 days from the receipt of their credentialing information.
5. Develop a credentialing process that is sustainable
Establishing a credentialing workflow may pose difficulties, but it proves beneficial in the long run. Regardless of whether the credentialing process is outsourced, your workflow must ensure the retention of all necessary forms and documents. In a practice with multiple physicians, re-credentialing constantly arises, making it highly advantageous to have a workflow that can effectively handle this task.
6. Do not make the assumption that all payers permit billing a new physician as locum tenens.
You have the option to bill a new physician as locum tenens with certain payers if their credentials are not yet complete. However, not all payers allow this practice. It is advisable to complete the physician's credentialing process in order to bill normally. If that is not possible, it is recommended to contact the payers to determine their policy on locum tenens billing.
7. Ensure that you regularly update all contact information for physicians
Ensure that your credentialing coordinator keeps accurate and current contact information for all physicians. It is crucial to have direct contact in order to efficiently handle any credentialing or re-credentialing matters. Additionally, the credentialing process requires submitting multiple forms, and it is vital to maintain clear communication throughout.
8. Ensure that every physician has a clear understanding of the obligations and expectations placed upon them.
It is essential for every provider to be aware of their obligations regarding credentialing or re-credentialing. Upon extending a job offer, it is important to clearly communicate to the new employee the specific information required, such as their work and education history, certification and license details, as well as malpractice liability certification, among other necessary documents.
9. Perform a personal background check at the outset
Numerous practices opt to perform independent background checks on prospective physicians, ensuring their training, licensure, and employment records are accurate before extending a job offer. While it may seem excessive, this precautionary measure effectively prevents any potential complications stemming from licensing issues after hiring.
10. Gain a complete understanding of the regulations in your state
Physician credentialing laws may vary by state, and some states may have reciprocity agreements with payers and other credentialing organizations from different states. If a physician is already credentialed with a payer in another state and plans to join your practice, the payer may expedite the credentialing process for their new position.
Having a clear understanding of credentialing processes can greatly improve the efficiency of practice and accelerate cash flow. Issues with medical credentialing services can be costly and hinder productivity, highlighting the need for a well-established procedure to ensure credentials are always up to date. To ensure you experience a seamless credentialing process, connect with ProLocums.
Nearly a decade ago, doctors embraced locum career opportunities, exploring various aspects of their lifestyles. Since then, the healthcare industry's reliance on locum workers has grown significantly. Today, 94% of healthcare employers report utilizing locum professionals, a sharp increase from 74% just five years ago.
This shift in demand has brought about a change in perceptions. Once viewed as a fallback for physicians unable to secure permanent positions, locum roles are now highly coveted. As the Nevada Daily Mail reports, “Today, such positions are becoming coveted, attracting high-quality physicians.”
As the need for locum doctors, dentists, and clinicians continues to grow, so do the career opportunities within this field. Whether you prefer traveling, moonlighting, or seeking alternative work environments, the type of locum physician job you choose can reveal a lot about your professional identity.
1. The Traveler
For those with a love for adventure, locum work offers the perfect blend of career and travel. Whether you want to spend winters on the West Coast and summers on the East or explore new states, locum professionals are needed across the country. From Maine to California, Texas to Minnesota, and Florida to Washington, opportunities abound. Partnering with ProLocums means that the state licensing process is handled for you, and travel and housing costs are covered, making it easier to focus on your work while exploring new places.
2. The Moonlighter
Locum work has become a popular option for physicians looking to supplement their income. Whether it’s to pay down medical school debt or achieve other financial goals, moonlighting through a locum can be a lucrative and flexible option. As highlighted in our original article, these professionals often use their off-hours or extended vacation time to earn extra income, experiment with new practice styles, or explore different locations.
3. The Alternative Seeker
For some, locum work is a way to escape the challenges of traditional medical practice. From bureaucratic headaches and reimbursement hassles to malpractice concerns and stress, the demands of independent practice can be overwhelming. Locum offers an alternative that allows professionals to achieve a better work-life balance. This option is increasingly attractive to those who want to continue practicing medicine without the burdens associated with a permanent position.
4. The Test Driver
New physicians, residents, and fellows often find locum physician jobs to be an ideal way to explore different career paths before making a permanent decision. By taking on short-term assignments in various settings, they can gain valuable experience and insight into different practice environments. This approach allows them to test the waters and determine what type of employment suits them best, without the long-term commitment.
5. The Sunset Seeker
As experienced healthcare professionals approach the end of their careers, many choose to transition into locum work. This allows them to continue seeing patients and earning income on a more flexible, often part-time schedule. Some of these professionals may have previously retired but have returned to work through locum, attracted by the flexibility and the opportunity to remain active in their field. For many, locum is a fulfilling way to cap off a long and successful career.
6. The Transitional Professional
Locum jobs online can be a convenient option for healthcare professionals who are between long-term commitments. This category includes residents looking to gain experience before settling into a permanent role, as well as mid-career professionals considering a career change. By taking on shorter-term locum positions, they can maintain their skills and income while exploring new opportunities and figuring out their next steps.
7. The Country Doctor
A new breed of country doctors is emerging through locum work. Rural healthcare facilities have a growing need for locum professionals and this type of work appeals to those who want to make a meaningful impact in local communities. For healthcare professionals who are passionate about serving underserved areas, locum work in rural settings is an opportunity to provide essential care where it’s needed most.
No matter what drives you to pursue locum work—whether it's travel, financial goals, or a desire for flexibility—you’ll find that the opportunities are as varied as the professionals who seek them. With ProLocums, you can be confident that you’ll always find the best locum jobs online and the most supportive recruiters in the business.
Discover more about the locum lifestyle with us. Connect with ProLocums today!
08/20/2024
At ProLocums, we believe there is no one-size-fits-all way to organize partnerships with hospitals, and the same applies to our relationship with the physicians we hire to care for patients.
Whether you are employed and receiving a W-2 or are an independent contractor physician receiving a 1099 depends on various factors including specialty and role. Most physicians have been W-2 employees at some point, so they inherently understand this model. The independent contractor (IC) model is a little more foreign to many, so it is important to understand the pros and cons of this tax status.
Transitioning from an employed model to being an independent contractor physician (ICP), or starting your career as an independent contractor, presents a variety of often bewildering questions. One of the first is likely about the difference between forming an LLC and an S Corp.
Choosing the right business structure is a complicated question that depends on your state, personal financial goals, and family needs. To help physicians navigate these choices, we've teamed up with DocWealth.io, which specializes in providing CPA services for 1099 physicians to maximize their earnings. Consulting with a professional like DocWealth.io can help you come up with a plan that fits your particular situation and needs.
In this article, we will discuss why being a 1099 physician is the best option and explore whether you should form an S Corp or an LLC to maximize your financial benefits.
When deciding between forming an LLC or an S Corp as a 1099 physician, it's crucial to understand the distinctions and benefits of each structure.
S Corporation (S Corp): An S Corp, or S corporation, is a type of business entity that offers the advantage of pass-through taxation. This means that the company's profits and losses are passed directly to the individual owners, who report them on their personal income tax returns. This structure helps avoid the double taxation commonly associated with traditional C corporations. Owners of an S Corp can also save on self-employment taxes, as they can take a reasonable salary and distribute remaining profits as dividends, which are typically taxed at a lower rate. [not subject to additional self employment taxes.]
Limited Liability Company (LLC): An LLC, or limited liability company, blends the benefits of a corporation with the flexibility of a partnership or sole proprietorship. LLCs are relatively easy to establish and operate, offering significant flexibility in how they are taxed and how profits and losses are allocated among the owners. The members of an LLC are not personally liable for the company's debts and obligations, providing a layer of personal asset protection. Profits can be distributed among one or more members, making it a versatile choice for many business owners.
Contrary to popular belief, the primary purpose of forming an LLC for physicians is not necessarily to shield from liability, but to create an opportunity to save money through electing S Corp taxation.
How Does an LLC Help Lower Your Tax Bill? An LLC can choose to be taxed as an S Corp, allowing the business owner to take advantage of pass-through taxation while also potentially reducing self-employment taxes. By electing S Corp status, the physician can receive a portion of their income as a salary (subject to payroll taxes) and the remaining as a distribution (not subject to self-employment tax), leading to overall tax savings.
Many independent contractor physicians opt to form an LLC for its ease of setup and then elect S Corp taxation for federal tax benefits. This setup allows physicians to benefit from the simplicity of an LLC while enjoying the tax advantages of an S Corp.
Here’s how it works:
1. Formation and Election:
2. Revenue Flow:
3. Salary and Distributions:
As both the employer and employee, the independent contractor physician can significantly reduce self-employment taxes. For 2024, the self-employment tax rate is 15.3% on earnings up to $160,200, with an additional 2.9% on income above this threshold. By balancing W-2 wages and distributions, physicians can save thousands of dollars annually, primarily on payroll taxes, while still meeting their income tax obligations. This strategy offers substantial savings for independent contractor physicians.
Dr. Smith owns Smith Medical, LLC. ProLocums pays Smith Medical, LLC $325k through 1099 payments. Smith Medical, LLC then pays Dr. Smith a $125k salary via W-2. As a result, Dr. Smith’s payroll tax is calculated only on the $125k salary instead of the entire $325k.
Payroll Tax Implications Without an LLC:
Payroll Tax Implications With an LLC:
By structuring his income this way, Dr. Smith saves over $10,000 in payroll taxes.
The next common question is, “What about the $200k that I’m not taking as wages?” That $200k remains your money and can be accessed through owner distributions or dividends. You can transfer these funds from your business bank account to your personal account with ease. The advantage here is that this $200k is not subject to payroll tax, though it is still subject to income tax.
Forming an LLC and electing S Corp taxation has numerous benefits, but there are also potential downsides. These include compliance with additional tax rules and regulations specific to S Corps. Physicians considering this option should weigh the benefits and drawbacks and consult a tax professional before making a decision. For more information, visit DocWealth.io.
In recent years, the tax landscape for independent contractors has become increasingly complex, making much of the existing online information outdated. Consulting with a tax professional is crucial for understanding your specific situation.
Qualified Business Income (QBI), outlined in Section 199A of the tax code, refers to net income from a qualified trade or business eligible for deductions under the Tax Cuts and Jobs Act of 2017. For independent contractor physicians, this income is eligible, but only if it falls under certain thresholds:
QBI Example:
Understanding QBI and its implications can significantly impact tax planning and savings for independent contractor physicians. For more detailed advice tailored to your circumstances, visit DocWealth.io.
The 2017 tax law that introduced QBI also capped state and local tax (SALT) deductions at $10,000, targeting high-income earners like physicians. To counteract this, many states have introduced or proposed a Pass-Through Entity (PTE) Level Tax. If your state offers PTE, you can pay a portion of your state income tax through your LLC and receive a federal deduction.
For Example:
This strategy allows high earners to navigate the SALT deduction cap effectively.
Organizing an LLC and paying yourself as an employee adds complexity but can lead to substantial savings. In the examples above, Dr. Smith could save:
These figures don’t include potential savings from retirement contributions or business deductions. While these examples are simplified and may not apply to your specific situation, the potential benefits are significant.
For personalized advice, consult your CPA or schedule a free 30-minute session with DocWealth.io.
07/15/2024
Physician income has been on a steady rise, with the average compensation for U.S. physicians escalating from $352,000 in 2022 to $363,000 in 2023 according to the Medscape report. However, these figures vary significantly across specialties and demographics, particularly gender. In 2023, male physicians earned an average of $91,000 more than female physicians, a stark 29% difference.
The disparity is even more pronounced among specialists. Male specialists earned an average of $435,000 in 2023, compared to $333,000 for their female counterparts, resulting in a 31% difference. Encouragingly, the gender pay gap is much narrower in locum positions, averaging about 15%. In some specialties, there is no gap, and in others, women earn more than men.
Here is a detailed analysis of the average compensation across six specialties and how it varies by gender as per the Medscape report.
Anesthesiology is among the highest-paying specialties and continues to grow. Average compensation for anesthesiologists increased by 10% in 2022 and an additional 5% in 2023. In 2022, male anesthesiologists earned an average of $459,000, while female anesthesiologists earned $419,000. Although a pay gap exists, it is smaller compared to other specialties and is shrinking; the gap decreased from 17% in 2021 to 10% in 2022.
For locum anesthesiologists, the pay gap is minimal. Women earned an average of $298 an hour, while men earned $310 an hour, a difference of just under 4%.
Cardiology is the third-highest-paid specialty, with an average income of $525,000 in 2023. Although specific gender pay gap data for cardiologists is not available, the overall average gender pay difference for specialists is 31%, translating to more than a $100,000 difference.
Locum compensation for cardiologists is more equitable. Women earned an average of $246 an hour, compared to $247 for men.
In family medicine, male physicians earned an average of $282,000 in 2022, while female physicians earned $230,000, a 23% difference. This gap, however, is narrowing; it was 26% the previous year. Locum compensation for family medicine doctors shows no disparity, with both men and women earning an average of $117 an hour.
General surgeons earned an average of $423,000 in 2023, though gender-specific data was not provided. Interestingly, in locum positions, female general surgeons earned 11% more than their male counterparts. Women earned an average of $179 an hour, while men earned $159 an hour.
While Medscape did not report on the gender pay gap for neurologists, the average compensation rose from $313,000 in 2022 to $343,000 in 2023, a nearly 10% increase. In locum roles, male neurologists made about 5% more than female neurologists, with average hourly rates of $255 and $242, respectively.
The field of obstetrics and gynecology has one of the smallest pay gaps in medicine. In 2022, male OB/GYNs earned an average of $349,000, while female OB/GYNs earned $329,000, a 6% difference. By opting for the latest locum jobs, women earned slightly more than men, with hourly rates of $164 for women and $161 for men.
These figures are averages, and individual compensation can vary widely within each specialty. Nonetheless, there are ways for physicians, regardless of gender, to increase their earnings:
By leveraging locum opportunities, understanding their worth, and negotiating effectively, physicians can work towards closing the gender pay gap and ensuring fair compensation for their expertise and hard work. Visit the ProLocums website to find more locum opportunities.
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