Insurance Provider Credentialing
The first thing to remember is that initial Provider Credentialing is Free. Our expert staff reaches out to the carriers of your choice to obtain network status. Free at startup and a very reasonable fee per provider afterward.
Generally speaking, Provider Credentialing is a process that supplies insurance companies with information that determines if the provider is qualified to practice, bill, and be compensated for a specific medical service. It’s the first step of, and the foundation for, all your interactions with governmental and private payers. It’s the process insurance companies employ to verify your physician’s licenses, education, background, and other information. During the credentialing process, the contract that sets the reimbursement rates and rules of billing is created.
Hence, we offer our credentialing service as an integrated part of our coding and billing service. We verify contract status, collate your payer contracts, and obtain fee schedules for each payer.
What we do:
- Verify license, certification, Drug Enforcement Agency ID, and National Provider Identification (NPI).
- Assist newly licensed clinicians in acquiring their NPI.
- Collect and securely maintain supporting documents needed for credentialing applications. For example, driver’s license, birth certificate, Social Security number, diploma, and curriculum vitae.
- Prepare a separate application packet for every government and commercial insurance carrier, plus submit an application(s) on your behalf.
- Follow up with insurance carriers to verify receipt of applications, respond to additional information requests, and track application processing to ensure timely approval.
- Confirm and Maintain Credential Approvals and Re-credential on the provider’s behalf, as needed.
Contact us for a Complimentary Consultation.