OUTSOURCED CREDENTIALING SERVICES

  • Serving all specialties
  • Serving all States
  • EHR Flexible Solutions
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PROVIDER CREDENTIALING SERVICES.

At our company, we specialize in offering comprehensive credentialing services tailored to meet the needs of various healthcare providers, including Physicians, Hospitals, Home Healthcare agencies, laboratories, and Durable Medical Equipment (DME) providers. Our primary goal is to optimize revenue potential for our clients by streamlining the credentialing process.

By entrusting your credentialing needs to us, you can focus on what matters most – providing exceptional patient care. Our commitment to excellence and attention to detail will help you navigate the complex world of credentialing, allowing you to maximize your revenue potential and expand your practice with confidence. Partner with us today and experience the convenience and benefits of our expert credentialing services.

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.

Our Key Performance Indicators

7-14
Days Turnaround Time
0%
Reduction in A/R
88%
First Pass Clean Claims Rate
20-30%
Revenue Increase
90%+
Collection Ratio

Our Specialities

Cardiology
Surgery
GYN
Pain Management
Gastroenterology
DME
Ambulatory
Emergency Care
Family Medicine
General Surgery
Oncology
Orthopedic
Psychiatric
Rehab
Dermatology
Dental

Testimonial

  • Far far away, behind the word mountains, far from the countries Vokalia and Consonantia, there live the blind texts. Separated they live in Bookmarksgrove right at the coast of the Semantics, a large language ocean. A small river named Duden flows by their place and supplies it with the necessary regelialia.

    Marianne J
    Alabama
  • Far far away, behind the word mountains, far from the countries Vokalia and Consonantia, there live the blind texts. Separated they live in Bookmarksgrove right at the coast of the Semantics, a large language ocean. A small river named Duden flows by their place and supplies it with the necessary regelialia.

    Rayan C
    California
  • Far far away, behind the word mountains, far from the countries Vokalia and Consonantia, there live the blind texts. Separated they live in Bookmarksgrove right at the coast of the Semantics, a large language ocean. A small river named Duden flows by their place and supplies it with the necessary regelialia.

    Paul Smith
    Texas
  • Far far away, behind the word mountains, far from the countries Vokalia and Consonantia, there live the blind texts. Separated they live in Bookmarksgrove right at the coast of the Semantics, a large language ocean. A small river named Duden flows by their place and supplies it with the necessary regelialia.

    Eric Jones
    Texas