Medical Credentialing Services

Get Best Provider Credentialing Services at No Upfront Fee.

Physician credentialing is process of verification for a physician’s experience, education, training & licensure from primary sources.

The same process is also named as Physician Credentialing & Provider Enrollment.

Physician credentialing services for medical providers and healthcare professionals
MEDICAL PROVIDER CREDENTIALING IS REVENUE
THERE IS NO REVENUE WITH OUT PROPER PROVIDER ENROLLMENT. HAVING BEST SERVICES HELPS YOU SECURE HEALTHY CASH-FLOW.
AFFORDABLE MEDICAL PROVIDER CREDENTIALING SERVICES
PAY AS LOW AS $299 PER PROVIDER PER MONTH AND GET PHYSICIAN CREDENTIALING SERVICE FOR UNLIMITED PAYERS
IT CAN'T BE BETTER THAN THIS
NO UPFRONT FEE, PAY AS YOU GO, PAYER EVALUATION TO GET THE BEST FROM YOUR AREA, BEST CONTRACT NEGOTIATIONS.
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HOW ARE WE DIFFERENT

QUESTIONS ABOUT MEDICAL PROVIDER CREDENTIALING SERVICE

The standard time frame for provider credentialing application process is 30-120 business days, Some insurances even take more than 120 days and some process applications within 45 days.

Yes & No.

It depends on your specialty, patient volume and state you are practicing in but it is always recommended to complete your Medicare provider enrollment process before applying for other insurances.

Your dedicated account manager will help you evaluate right payers according to your specialty and location. We help you negotiation contracts in best possible way. Transparent and timely client communication is main focus of our physician credentialing service. We send bi-weekly application status updates.

To complete medical provider credentialing process you should have following documents.

  • State License
  • Malpractice certificate
  • DEA certificate
  • Resume
  • Board certificate
  • IRS letter (EIN letter)
  • Business Voided Check
  • General Liability insurance
  • Educational and Professional history of medical provider
  • Article of Incorporation in case of business

We have also given detailed list checklist section. Do scroll down to check that.

If you are paying more than $300 to $500 per provider per payer. You are wasting money. We can help you reduce this cost drastically.

No, you will have to wait until your medical provider credentialing and contracting application gets approved.

It depends on multiple factors such as your Specialty, The state you are practicing in and the Insurances you are applying for.

We can help you get your individual or business NPI within 24 hours for FREE of Cost.

Yes, you will either get an approval letter via mail or an email from medical insurance payer on approval of your physician credentialing application.

in-house or outsourcing

MEDICAL PROVIDER CREDENTIALING

No doubt that medical provider credentialing is an important aspect for running a successful medical practice. You can hire a physician credentialing specialist or outsource the process to right medical provider credentialing company.

In both cases things can be difficult to handle.

Our Physician Credentialing Service can save your time by avoiding following major mistakes.

  • Submitting provider credentialing applications with erroneous data.
 
  • Submitting physician credentialing applications to wrong departments.
 
  • Submitting multiple applications.
 
  • Incorrect contracting or unable to understand the provider contract with insurance payers.
 
  • Irregular follow ups.
 
  • Provider enrollment with HMOs & PPOs without completing Medicare & Medicaid enrollment
 
  • Signing an insurance contract without even reviewing it.
 
  • Accepting the fee schedules as it is where it can be negotiated.
 

How to Choose Best Medical Provider Credentialing Company.

Choosing right medical credentialing company can help you grow faster by saving a lot of time and effort to meet your physician credentialing goals.

Credentialing company should be able to meet the dead line agreed as delaying provider credentialing can effect your cash flow forecast.

The dedicated expert from medical provider credentialing company should be able to suggest top medical insurance payers in your area.

He should also be able to segment and prioritize medical provider credentialing application process.

Medical credentialing company should also take ownership for handling all re-validation or rec-credentialing tasks.

The company should be able to provide bi-weekly application status reports.

The credentialing company should charge competitive fee.

Insurance credentialing services - Tips to choose best medical insurance credentialing company.

What you will get

Our physician credentialing service includes

Step wise medical insurance credentialing process

What is medical provider credentialing?

Physician credentialing is process of  primary source verification for physician’s education, experience and other related credentials. It is to ensure that medical provider is competitive enough to render the healthcare services.

Further it is to ensure that patients get highest level of care from safe hands.

This Process is also known as medical provider enrollments and medical physician credentialing.

The objective of medical credentialing process is to make sure that all the information provided by medical provider in his or her physician credentialing application is correct.

This provider credentialing process helps to minimize the risk of fraud.

A primary source for your educational background could be the medical school you attended in order to earn your medical degree or certificate.

For work experience it could be your previous employer.

For licensure it will be your state medical board.

It also encompass verification of training and education through the American Medical Association or the Educational Commission for Foreign Medical Graduates if the medical provider got his medical education outside the United States

Medical insurance payers can also verify Medicare sanction information from National Practitioner Data Bank on closed and settled claims history.

How does medical provider credentialing process works?

First Step:

The first step in medical provider credentialing process is to complete your CAHQ application and upload all the required documents.

Second Step:

The second step is to reach out to all the healthcare insurance companies that you are planning to join and request application packets, Complete and submit back.

Third Step:

The third step to complete your medical provider credentialing process is to sign a contract with the medical insurance company and accept terms and conditions. Singing a contract with an medical insurance company makes you eligible to seek payment against the medical services that you are rendering.

On CAQH directive, Medicare & Medicaid always tend to improve the medical provider credentialing system in order to ensure patient safety and reduce the risk of fraud & abuse.

Due to above mentioned reason, physician credentialing process is tedious and time consuming process with a lot of requirements. It can take 30 to 120 business days.

It also varies payer to payer as some insurances may process your application within 15 days and some may take up to 6 months.

 

Why medical credentialing is so important?

Physician credentialing is important to build a patient network. No matter what specialty and caliber you have, in order to gain a good patient volume you need to be listed on the insurance panels.

Healthcare insurances will only refer their patients to you if you are one of their participating or in-network medical provider.

You revenue cycle depends on provider credentialing.

Patients are the most basic need of a your medical practice so to make sure that you are not losing a single patient you should get into every insurance plan that is available in your area.

In simple words, it’s all about your cash-flows, if you have an existing medical practice or planning to start one, you should be well aware that all your plans run around cash-flows, which is dependent on proper provider enrollment service execution.

Proper medical credentialing enables you to accept more patients.

Physician credentialing with insurance payers is the first step to generate continues & healthy cash-flows.

Physician credentialing ensures that you accept all the patients. You will not have to say “NO” to any patient as you don’t accept that healthcare insurance they have.

In-network contracting helps you build strong brand.

Medical credentialing paves your way to payer network contracting, which means you will be get patients from other physicians from same network, this helps strengthen the relationship and build reputation with other providers & more patients.

Payer in-network contracting ensures more revenue for in-network providers

Its worth considering while creating your business plan.

If you will not get yourself or new hires credentialed in timely fashion, you will not be able to bill the insurance payers.

It may push you to plan cash arrangements from other resources.

While creating your medical practice business plan, always keep in mind the time it will take to get your in-network reimbursements for patients treated by newly credentialed providers. Outsourcing your credentialing process to right medical credentialing company can help you make best estimate.

Further you should also consider from what date newly hired medical providers can start seeing patients as if you will start billing for their patients on a future date, You need to know the cutoff date from where the payer can cover your past bills.

Commercial plan contracts do not have any retroactive billing provisions, so you will only be able to receive full reimbursement after your effective date.

Physician Credentialing Checklist

Once you are ready to start medical provider credentialing process, keep your documents ready related to following areas.

  •  

Provider information

Provider Name

NPI

Specialty 

SSN

DOB

Provider Birth Country & State

Contact Number

Home Address

CAQH User Name & Password

NPPES User Name & Password

Office Hours

Practice information

Practice Name

Tax ID

Practice NPI

Practice Specialty

Service location 

Mailing Address                                

Practice Phone Number

Practice Fax No

Owner information

Ownership Percentage

Owner Name

Owner DOB

Owner SSN

Owner Home Address Owner Cell 

Owner NPPES User Name & Password 

Owner Birth Country & State

Our Physician Credentialing Services

SPECIALTIES COVERED

WE HANDLE BUT NOT LIMITED TO

Medical Provider Credentialing

  • Clinics
  • House calls
  • Private practices
  • Telehealth or Telemedicine setups
  • Surgery centers
  • Hospital Privileges
  • IPA Affiliations
  • Hospitals
Medical Credentialing services, Types of Medical practices we cover for medical provider credentialing

INSURANCES WE COVER

Federal Plans like Medicare, Medicaid, Tricare, etc.

National Plans such as Aetna, Cigna, BCBS, UHC, Humana etc.

All Managed Care & Regional Plans.

HOW DOES IT WORK

1-Contact

Simply explain what you want & leave your contact details. We will get back to you at our earliest.

2 - Information

After reviewing your query, we will get back to you as soon as possible to have clear idea regarding your requirements as well as we will help you to prepare specific documents required to complete the application.

2 - Submission

On your Go Ahead call, Our expert will update and submit the application to related departments.

Dedicated Manger will follow up with all verification resources as well as keep you posted regarding updates.

 

AFFORDABLE FEE

Get Following Covered for Only $ 299 per Month per Provider

  • Life time support
  • No approval, No Fee
  • Get Credentialed with as many insurances as you want
  • NPI registration & Maintenance
  • CAQH Registration & Maintenance
  • Medicare & Medicaid Enrollment
  • Credentialing & Re-Credentialing with Commercial and HMOs.
  • Contracting & Negotiations
  • Direct Deposit Setups to avoid extra workload.
  • Demographic Updates.
  • Quarterly Directory Verification

WE LOVE TO HELP

Leave your question & contact. We will get back to you at earliest.

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