Provider credentialing is the process of getting a healthcare provider affiliated with a payor. Only then can a provider treat a patient with insurance and get reimbursed. Therefore a provider would have to get enrolled and credentialed with the maximum number of payors. This would enable him to see more patients. Our physician credentialing services will ensure this for you.

The process of medical credentialing with a payor certifies that a provider meets the standards for delivering clinical care. The payor verifies the provider’s education, license, specialty certifications, etc., before accepting him into their provider network.

Hence provider credentialing is a critical part of the revenue cycle. The physician’s financial health is dependent on getting credentialed with the maximum number of payors.

Credentialing is complete when the provider enters into a contract with the concerned payor.

Insurance credentialing must be redone after a certain period and must be done well in time to avoid getting a suspension. Our insurance credentialing services will monitor your situation and get the re-credentialing done in time.

Our credentialing services take care of all the paperwork and see that your credentialing process is smooth.

This process enables a healthcare provider to be enrolled by a payor for the services he provides. The payor has the required data to process claims for the services a provider delivers. The enrolled provider is eligible to get reimbursed by the payor. Provider credentialing and enrollment is part of the medical insurance billing services that a billing company offers.

As much as a patient’s medical insurance verification is essential for a provider, credentialing is even more critical. Our credentialing services will ensure that your doors remain open for patients.

Our doctor credentialing services take care of all the paperwork involved in getting yourself credentialed/enrolled with federal and commercial insurance companies. We understand the policies of payors and what information they require to get you credentialed fast. Our team continually monitors and follows up applications so that they are processed in time. As one of the long-standing credentialing companies, we have the experience to resolve issues that come up quickly so that your revenues are not impacted. 

We help you with the following medical credentialing services.

• Medicare and Medicaid Provider Enrollment and Credentialing
• Commercial Insurance Provider Enrollment and Credentialing (i.e., Aetna, Anthem, BCBS, CIGNA, Humana, TriCare, UnitedHealthcare and many more)
• Medicare Revalidation
• CAQH (Council for Affordable Quality Healthcare) Registration
• NPI (National Provider Identifier) Registration (Type I and Type II)

Our company has been in the healthcare industry for over two decades. Our countless clients stand testimony to all our billing services, including provider credentialing services.

• You may be starting a new practice or joining a new practice or enrolling with a new payor; regardless of your case, a dedicated manager is representing you with federal and commercial payors. The managers are experts at insurance credentialing for physicians.
• We collect all the necessary documents, fill up the applications and complete all paperwork required by payors on your behalf.
• All of your documents are maintained on our secured document management systems.
• Maintain and update the CAQH profile.
• Monitor the status of the application with each payor and follow through to completion.
• We follow all contracts with payors through to contract load date and provide a copy of the fully executed contract and fee schedules to your practice.

Simply put, our medical billing and credentialing services will skillfully manage the entire enrollment and credentialing process from start to finish for one low flat fee!