Credentialing & Provider Enrollment
Credentialing and provider enrollment can be one of the most frustrating jobs for individuals who are unfamiliar with the process. Each payer has its own set of rules and missing just one step in process can cause weeks or months of delays before you are even notified that you’ve missed that step. Let DoctorsManagement get the job done quickly and efficiently.
Medical Credentialing Services
- Provider Enrollment & Credentialing
- Individual & Group Medicare Enrollment
- Medicaid Program Enrollment for Group & Individual
- Annual Credentialing Maintenance
- Telemedicine Credentialing
- CUA Approved Lab Enrollment
- NPI CAQH and PECOS Setup
Understanding the Medical Credentialing Process
Credentialing is an application process of organizing enrollment information and verifying a physician’s professional records to ascertain their eligibility to qualify a doctor to practice medicine and includes hospital privileges, malpractice insurance, education, board certification, professional references and additional information.
In order for organizations to attain primary source verification of the practitioner’s education, training, certificates, provider type, and licensure and maintain a file on each provider, they must be given permission to research their background, education, licensure, and professional certifications. Provider enrollment applications are part of the enrollment process and are filled out and this will determine the medical practice physician’s eligibility.
A physician must be credentialed for their scope of practice, including procedures and special equipment they will use in those procedures.
DoctorsManagement offers credentialing services to startups and established facilities, including:
- Nurse Practitioners
- Physician Assistants
- Urgent Care Providers/Urgent Care Facilities
- Behavioral Health Providers
- Physical, Occupational & Speech Therapists
- Labs, ASCs & Imaging Facilities
DoctorsManagement does not provide credentialing for FQHCs and Rural Health Clinics, Hospitals, or Universities.
Reliable Credentialing Service You Can Trust
We Understand That Your Revenue Depends Upon Our Response Time
Whether you’re starting a new practice or expanding a solo or multi-specialty medical practice, our team moves quickly to get you credentialed with the necessary payers. We also do enrollment for providers of community hospitals and work with a wide variety of specialties including dental practices. We keep you in the communication loop without overwhelming you with details.
Transparent Communication and Fast Response Time
Unfortunately, we hear countless stories from providers about their experience with credentialing vendors who either: forgot to submit their application; issues with beneficiaries; missed a crucial step in the process; or simply won’t return their phone calls. These setbacks are unacceptable.
At DoctorsManagement, we work diligently to help you begin receiving payment as quickly as possible.
Full-Service Provider Enrollment Services Include
- Full Credentialing/Enrollment: Our staff handles it all. We will complete all of the necessary Medicare service forms and applications, CAQH, NPI enrollment, Medicaid services and other third-party payer applications.
- Revalidation: We can complete the task of getting the provider(s) and/or group revalidated with Medicare by processing all of the necessary paperwork.
Get Credentialing Help With Provider Enrollment
- Schedule your free consultation
- Learn how we avoid credentialing delays and denied claims
- Receive a custom quote with payment options that work for you
Reduce Your Compliance Burdens with Trusted and Reliable Experts
The demands on today’s healthcare professionals are overwhelming. Not only are you expected to achieve clinical excellence and patient satisfaction, but you must also meet financial and operational objectives. This requires more work than ever before.
Whether you are a single-provider practice or a multi-specialty group or hospital, our team facilitates the process of credentialing and enrollment so that you can focus on caring for patients and building your business.
Join thousands of other providers and you too can benefit from our proven systems of faster and easier credentialing without unnecessary delays and headaches. We’ll even keep you informed throughout the process.
With DoctorsManagement, you receive bi-weekly updates – plus a post-credentialing resources book that contains those “hard-to-find” forms for the next time you need to credential or revalidate.
Or contact us for your free quote via phone at 800-635-4040 or email at [email protected]
Medical Credentialing and Provider Enrollment Services
DM can assist you with provider enrollment and becoming an in-network provider so that you can receive reimbursements from each carrier.
DoctorsManagement specializes in Medicare, Medicaid, and all other Commercial/Private Insurances. Our goal is to relieve our providers and their staff from hours of filling out paperwork and waiting to speak with insurance Companies.
Provider Enrollment and Credentialing FAQs:
Q. How long does the provider enrollment process take?
A standard credentialing process can take 3 to 4 months based on the intricate guidelines. The application and approval process should take about 90 days. There are many complexities in provider credentialing and certain providers will require a longer time to become verified.
Q. What should the process look like with a Medical Credentialing Service Provider?
- Process should begin with reviewing your specific network need and evaluating top payers in your area.
- After final decisions are made, a contract is executed for the work
- The application process begins with gathering necessary documents from the provider and attaining a list of contacts at the insurance companies, sometimes online and sometime by submitting applications
- Attain confirmation that the application was received
- Provider will be informed of the executed documents in order for them to begin claim submission
Q. When you outsource your Credentialing, what should we look for in a medical credentialing company?
When utilizing an outsourced credentialing company, be sure that they respond to requests in a timely manner, they should provide excellent communication and complete transparency. They should take ownership in the process as your representative and let you feel that they understand your needs and you are in good hands.
Q. How does DoctorsManagement provide a complete physician credentialing service?
We assign them a Credentialing representative that they can communicate easily with and rely on. We offer to analyze their payers for their specialty and geographical location, as well as evaluate their contracts. We want providers to feel as though we are sitting in their office and are available when they need us.
Q. Do all credentialing firms have experience credentialing all specialties?
No, but most offer provider enrollment for providers across the United States in a vast array of specialties.
Q. Do all provider enrollment companies check the same information?
Not all agencies check the same information. This depends on the agency and the provider background and history. Some agencies will choose a background check, fingerprinting, national provider identifier information, and other additional information.
Q. What steps are involved in getting credentialed?
- Identify Required Documents
- Prioritize list of insurers
- Double-check for accurate information
- Complete the CAQH
- Get Verification
- Follow up to be sure
- Re-certify before your expiration dates
Contact us for your free quote via phone at 800-635-4040 or email at [email protected]