What is Credentialing?
Medical credentialing vets the medical providers such as doctors and nurses are trained and certified with the proper professional experience to provide healthcare services to patients. Be credentialed means the medical provider is holding the highest standard os safety in their line of work.
Why become medical credentialed?
Being credentialed means you can work with specific insurance companies and bill them directly for your services provided. Which in result mean more patients when looking for providers in network will go to you. By working with insurance panels, allows your patients to pay for services at a lower cost and can also benefits from carrier referrals
What is the process to becoming credentialed?
Being credentialed means you can work with specific insurance companies and bill them directly for your services provided. Which in result mean more patients when looking for providers in network will go to you. By working with insurance panels, allows your patients to pay for services at a lower cost and can also benefits from carrier referrals
Do I get to choose which insurance panels I want to work with?
with is entirely up to you. Most outpatient physician providers credential with 7-8 payors, whereas hospital-based physicians (in-patient) usually credential with 10-15 payors (pretty much any patient with any insurance that comes to hospital). Physicians working in tristate area (border of 3 states) like in our physician owner practice credential with 25 payors. Most behavioral health providers, Therapists (PT, OT, ST, ABA etc) typically select 6-7 panels.
How do I know which insurance company is best for me?
The insurance you work with will depend on your needs. Please contact us and we would be happy to go through the options with you.
What is the cost for services?
How long does it take to get credentialed?
How much time will you save?
How many hours of work does insurance credentialing take?
Are you guaranteed to get on the panels you apply for?
No. Eligibility for panels involves many factors, including (but not limited to) your location and areas of practice. If you are fully licensed, there should not be an issue with getting credentialed.
How can I track the progress of my applications with companies?
We will provide regular updates every 2 weeks and also provide you login to see the process.
Do I need to wait a certain period of time before I get on an insurance panel once licensed?
What is CAQH?
When does credentialing and recredentialing occur?
Credentialing happens before the provider is considered to work with insurance networks. Recredentialing is done every 1-3 years after original date of the provider to ensure the information is up to date for insurance panels.