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The Pediatric Pulse:
The Impact of Provider Credentialing on
Practice Management and Patient Care

Credentialing and recredentialing processes for pediatric physicians can vary significantly across insurance plans. We invite you to share your experiences with provider credentialing, including timelines for approvals, instances of delays or denials, recredentialing requirements, and any administrative challenges encountered. Thank you for your time and valuable input!
1.Which of the following best describes you?(Required.)
2.What is the name and location (zip code) of your practice/organization?
(List all that apply)(Required.)
3.What type of pediatric practice do you work with?
(Check all that apply)(Required.)
4.What percentage of pediatric patients in your practice are enrolled in Medicaid
(NJ FamilyCare/CHIP)?(Required.)
5.Which insurance plans do you currently accept?
(Check all that apply)(Required.)
6.How often does your practice credential a new provider?(Required.)
7.Who manages the provider credentialing process in your practice?
(Check all that apply)(Required.)
8.If applicable, which service/vendor do you utilize to manage provider credentialing?
9.What is the average time it has taken for initial credentialing with an insurance plan? (We understand this can vary per plan).(Required.)
10.Have you experienced credentialing delays beyond what the plan suggests as the timeline?(Required.)
11.How often have delays in provider credentialing or recredentialing impacted the practice's ability to see patients or bill for services rendered?(Required.)
12.What challenges have you faced with provider credentialing?
(Check all that apply)(Required.)
13.Which documents have been flagged or required resubmission in the past?
(Check all that apply)(Required.)
14.Which insurance plans are the most challenging in completing the credentialing and recredentialing process? (Please provide any examples).
15.Do insurance plans notify you of the status of applications during the process?(Required.)
16.Are insurance plan credentialing portals easy to use and navigate?(Required.)
17.Are insurance plan representatives responsive when credentialing issues arise?(Required.)
18.How would you rate your overall experience with provider credentialing and recredentialing?(Required.)
19.Is there anything else you'd like us to know about specific provider credentialing issues in your pediatric office? Are there any ways NJAAP can better support you in the process?
20.Please provide your name and contact information if you're open to follow-up discussions regarding this topic:
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