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Guide

Payer enrollment for CRNA groups

No enrollment, no payment. Here is what a new or growing CRNA group needs to get paid by Medicare, Medicaid and commercial plans.

The building blocks

  • NPIs: an individual NPI for each CRNA and a group NPI for the practice
  • Medicare enrollment: the group and each CRNA, usually through CMS's online enrollment system
  • Reassignment: each CRNA reassigns Medicare benefits to the group so payments go to the group's account
  • Medicaid: enrollment with your state program and any managed care plans
  • Commercial plans: credentialing and contracting with each insurer you expect to see
  • Electronic payments: EFT and electronic remittance set up in the group's name

Timing

Medicare is often the quickest; commercial credentialing commonly takes longer. Start applications as soon as the group exists, and track every one.

Keeping it current

Revalidation, address changes, new CRNAs joining and licence renewals all need updates. Lapses cause denials that are hard to recover.

This article is general information, not billing, legal or tax advice. Payer rules change; always check current guidance.

Sources

Free checklist

CRNA Credentialing and Enrollment Checklist

The documents and steps you need to get a CRNA enrolled with payers and billing under your group.

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