Medical Credentialing Services
We provide Medical Credentialing Services to healthcare providers. The service requires evaluating the qualifications and practicing history of a doctor to establish competency. This process includes a review of a doctor’s completed education, training, residency, and licenses. It also includes any certifications issued by a board in the doctor’s area of specialty. Hospitals, insurance providers, Medicare and Medicaid conduct medical credentialing to determine which physicians meet their requirements prior to permitting them to practice in their network. These entities continue to do so, on a regular basis as dictated by states, regulatory bodies and accrediting organizations. While this may seem like a simple, straight-forward process, each hospital and third-party agency requires their own specific type of medical credentialing processes, forms, rules and requirements. Therefore, it is imperative to know the specifics of each hospital or agency in order to save time, money, and headaches. Without specific knowledge of what is required or not completing the forms accurately credentialing could take months.
We provide these services for facilities, physicians, nurse practitioners, and physician assistants for all specialties.
Services Include:
- Completion of all initial enrollment forms for hospitals and insurance plans
- Maintenance/re-credentialing for hospitals and insurance companies
- Set-up and maintenance of CAQH national database
- Management and follow-up of the enrollment process for both hospital and insurance participation
- Renewal of provider contracts, state licensures, and DEA certificates
- IDTF enrollment
- Storage and distribution of CME information to the appropriate entities
- Obtain NPI numbers
- Tax ID Changes
- Add new practice locations
- Billing and practice address changes