Our Step-by-Step Credentialing Services Process
We offer our credentialing services 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. At ebix, Inc., credentialing specialists handle both credentialing and contracting to ensure providers are correctly on panels. Initial Physician Credentialing is free, and the fee per provider afterward is very reasonable.
Week 1: Strategy and Information Gathering Credentialing Services
During the first ten days after the agreement is signed, we will ensure that every relevant payer is included. Your credentialing services account manager will assist you in ensuring we have all the necessary information to submit and process your applications, along with the payer review.
Weeks 2–5: Application Submission and Follow-Up Credentialing Services
The credentialing process starts by submitting a request to join the insurance company’s network and providing your information. Most large insurance companies use CAQH to access your license, DEA, CV, W-9, etc. Some of them require a letter of interest (LOI), and others want you to submit a form on their website. Regardless of how they do it, we will handle all these steps. Therefore, the follow-up process progresses seamlessly.
Weeks 6–9: Follow-Up and Contracting Credentialing Services
We will keep in touch and expect your application to progress through the payers’ credentialing process. Once your application has made it through the initial process, we will verify it transitions smoothly into the contracting phase.
Weeks 10–16: Contract Negotiations and Effective Dates Credentialing Services
You will start receiving agreements and seeing results soon. The Payer agreements are reviewed and sent to you for your signature unless negotiation is needed. Once signed, they will be returned to the payer for processing. The loading process with some payers can take an additional 45–60 days. We’ll review your payer list to ensure we have effective dates and provider IDs for all relevant payers. We will work with you to provide this information to your billing company or department.
Our services for Provider Credentialing include:
– Thorough verification of your licenses, certifications, Drug Enforcement Agency IDs, and National Provider Identifications (NPIs). This ensures that your credentials are up to date and compliant with all applicable regulations.
– Assistance for newly licensed clinicians in obtaining their NPIs, which is a critical step in the credentialing process.
– Collection and secure storage of all supporting documents required for credentialing applications, such as driver’s licenses, birth certificates, Social Security numbers, diplomas, and curriculum vitae.
– Preparation of separate application packets for every government and commercial insurance carrier and submission of the applications on your behalf. This saves you time and effort and ensures that your applications are completed accurately and submitted promptly.
– Follow up with insurance carriers to confirm receipt of applications, respond to additional information requests, and track application processing to ensure timely approval.
– Confirmation and maintenance of credential approvals, as well as re-credentialing on the provider’s behalf as needed. This ensures that your credentials remain current and that you can continue providing quality care to your patients.
