Credentialing Services
We provide credentialing and re-credentialing services to healthcare providers who want to participate with several insurances. This includes but is not limited to Government insurance and commercial insurance, Managed care, HMOs, and choice plus plans. Usually, we ask for the following information from healthcare providers to be credentialing, however, a relevant checklist is provided soon after you sign up with us:
• Current professional license(s)
• Current Drug Enforcement Administration and Controlled Drug Substance certificates
• Verification of education
• Post-graduate training
• Hospital staff privileges
• Levels of liability insurance
The credentialing process starts with requesting enrollment packets from government and commercial insurances. A signed package is sent to payers and then following up on the requests to make sure the timely processing of submitted correspondence. As soon as the credentialing the completed, we obtain provider numbers from the payers, setup EDI enrollments and start submitting claims for processing. A weekly follow-up report is also provided to the client for transparency and update. For re-credentialing, it is required after specific period of time when revalidation is required.