MAXIMIZE REIMBURSEMENTS & MINIMIZE LOSSES

OUTSOURCE CREDENTIALING SERVICES.

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Serving all 50 states

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Practice Management Expert

EXPERIENCE THE DIFFERENCE WITH OUR RELIABLE

PROVIDER CREDENTIALING SERVICES.

We provide credentialing services to Physicians, Hospitals, Home Healthcare, laboratories, and DME credentialing services, assisting the providers in getting better revenues. Our customized credentialing services facilitate the payer enrollment process when Physicians begin their first practice after Med school, change from one practice to another, add a new Physician to an existing group, or want to become enrolled with a new payer.

Let our skilled professionals care for your documentation needs, guaranteeing precise and reliable credentialing services. Eliminate the burden of paperwork and simplify the application process. Enhance your revenue cycle management and reduce claim denials with our efficient services. Gain a competitive advantage by choosing our cost-effective solutions, giving you an edge over others in the industry.

RCM MATTER’S PROVEN PATHWAY TO EXCELLENCE

OUR MEDICAL CREDENTIALING SERVICES PROCESS…

Gathering information

During provider credentialing, each insurance company requires specific documentation. Incomplete applications can cause significant delays. Hospitals collect doctors’ education, licensure, work history, and references before granting them practice privileges.

Appropriate insurance

To streamline the credentialing process, prioritize and complete applications based on your major medical billing insurer. Stay informed about individual insurers’ regulations for faster approvals. Prepare documents accordingly.

CAQH Enrollment

Many prominent insurance providers now mandate that facilities seeking partnerships undergo credentialing via the CAQH platform. This widely embraced program not only streamlines and expedites the entire process but also ensures its simplicity and efficiency.

Federal Regulations

Physician credentialing is a time-consuming and often frustrating process. Finding that the doctor is qualified in another state makes it worse. Thus, understanding state and federal legislation is essential. Each state has its own laws that may be helpful.

Verification

After submitting documents, verification begins. It can be done manually, with credentialing software, or through a trusted third-party company. The process confirms the physician’s credentials by contacting relevant institutions.

Follow Up

To verify qualifications, the company investigates references, companies, and schools. Credibility, standards, extra documents, interviews, and background checks may be required. It ensures applicants meet credential or certification requirements.

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