Credentialing and credentialing management are critical components to the success of your practice. Don’t risk practicing unknowingly without a license or having insurance payments delayed due to expired credentials, or incomplete or outdated information.
Many people are confused about what credentialing means. Credentialing is the process of communicating a provider’s qualifications to provide care or services to patients. Basically, you prove to an insurance company that you are a legitimate business and licensed provider.
Many of our competitors will “credential” a provider by just submitting a W9, a letter, and a copy of the provider’s license; our services go beyond this basic concept! We call our all-inclusive superior service…PEPI (Provider Enrollment and Practice Information) validation.
Did you know that each state and each payor has its own set of requirements? We credential to the most restrictive state. As other states implement more restrictions you are less likely to have claims disruption since we have created a workflow that accounts for many of those future restrictions.
Our credentialing services are for medical and dental providers. We offer:
- Out-of-network provider registration
- In-network contracting for commercial and government programs
- Medicare DME
- Medicare Part B
- Tricare