Comprehensive Credentialing Contracting Services

What is medical credentialling?

To ensure patients receive the best care, medical credentialling acts as a verification service to be certain that the providers have the qualifications and experience relevant to their service offerings. Credentialling companies exist to be a resource for providers so they can get the license verifications they need to begin seeing patients.

Why is medical credentialling important?

It is often time-consuming to get credentials such as licensure or education verified, which is why medical credentialing services exist. Healthcare offices or other organizations can work directly with an outsourced medical credential company to save them time on the tedious administrative paperwork. Healthcare providers should use these credentialing services to help patients feel confident that they are receiving the highest-quality care.

Provider and facility services offered

Starting a new practice or adding a physician to your group is more challenging than ever in health care today. Because of this, it is important that you get the necessary help early to start things off on the right foot. Whether you are a multi-specialty group, single-specialty group, or a solo practitioner, credentialing and start-up assistance should only be performed by experts.

With our team’s experience and dedication, your practice is sure to see a positive return on investment from our credentialing team! Below are just a few of the services we offer. Contact our office today to get a free personalized quote.

• Facility Privileges – credentialing packages for all providers including physician extenders.
• Commercial insurance credentialing
• Insurance renegotiation services
• Physician licensing
• Medicare credentialing
• Medicaid enrollment services
• Practice startup services
• Review of current contacts to compare to current reimbursement levels CAQH credentialing
• HIPAA: rules, standards and implementation guide
• Malpractice and general liability insurance services
• EHR/EPM consulting services
• Meaningful Use requirement management

Step #1: Completing and submitting unlimited re-credentialing applications

To make sure your credentials are on track with legal regulations, you’ll need to make sure you complete and submit the entirety of any re-credentialing applications.

Step #2: Following up on enrollment re-credentialing applications until processed

The next step in the contracting process would be to follow up on any of the previous applications you submitted. This could take some time as a part of the enrollment process but is often necessary when re-credentialing your services.

Step #3: Monitoring expirables with CAQH and payers

After you’ve submitted all of the necessary materials and followed up on your application, you’ll need to monitor potential expirable items such as:

• Licenses
• DEA
• Malpractice Insurance
• Hospital Privileges

Step #4: Keeping up-to-date CAQH profiles

The last step is to stay up to date with your CAQH profiles. You’ll want to continuously check in to make sure the information is still timely and accurate.