Credentialing or enrolling with government and commercial payers is challenging any way you slice it, but we’re here to eliminate the stress and increase the efficiency. As the first nationwide contracting and enrollment company, everyone else is still trying to play catch-up with our services and technology. We take care of everything from start to finish and keep you from spinning your wheels on the telephone for 4 hours a day. We offer physician credentialing services in all 50 states and work with thousands of providers every year. Our team of experts understands the insurance companies, and as former practice managers, we also understand what these insurance contracts mean to your bottom line. We provide contracting and insurance credentialing services to practices and hospitals of all shapes and sizes.
What are physician credentialing services?
Provider credentialing is a time-consuming process where attention to detail is critical. Even the slightest error in the application process can cause it to be rejected, which would mean delayed or loss of revenue altogether. This is also the reason why PPS and our credentialing service exists today. We are here to bridge the gap between physicians and a payer’s network.
Physician credentialing services may assist individuals under the following scenarios:
- When they are planning to start a new practice or are adding a new practice location
- When joining a new practice or relocating
- When they are planning to bring in a new provider to their existing group
- When changing TAX ID
- When carriers are requesting new or updated information
- When a provider desires to participate with an insurance plan
Credentialing services are an absolute necessity for any physician or provider who wants to optimize the performance of their practice. Proper enrollment ensures that payment is not delayed or denied by the insurance carrier. After all, these scenarios often arise even if the physician is competent to provide his/her services to patients.
Secondly, different insurance carriers have their own requirements when filling out their forms. This process requires due diligence and follow up to ensure that the payer’s credentialing process is attended to within the shortest time span possible. Otherwise, this process will always have an impact on revenue collected.
Outsourcing your provider credentialing department frees the physician, provider and/or administrator of valuable time and ensures an efficient provider enrollment process. An expert in credentialing services would also assist the physician in requesting or obtaining annual fee schedules which ensure that reimbursements are in line with the contracted rates.
Our physician credentialing service and contracting service include the following:
- CAQH Registration
- Commercial Insurance Credentialing / Physician Credentialing (Overview of Credentialing Process Here)
- Managed Care & Government Payer Credentialing
- Workers Compensation Credentialing
- Medical License Application Processing & Tracking
- DEA Registration & Tracking
- NPI Registration (Type I & Type II)
- Individual Medicare Enrollment
- Medicare Enrollment for Group & Reassignment
- Commercial Insurance Contracting
- Insurance Contract Negotiations
- Payer Fee Schedule Creation & Evaluation
- Management of all Credentials