PAP 113 - Credentialing/Re-credentialing Standards For Practitioners

Medical Credentialing Service, Get On Insurance Panels™

Medical Credentialing is the process of verifying information about physicians, medical staff, and healthcare providers of various kinds (nurses, counselors, chiropractors, etc.) to ensure legitimacy and experience. States and insurance providers conduct medical credentialing to determine which healthcare providers, medical centers, DME companies, hospitals, and private practices meet their requirements-and can accept patients’ insurance. Typically, hospitals and medical practices will either use their own employees, or hire outside services (like us), to facilitate the verification process between the practice/provider and the insurance companies.

Put simply: Do you want to accept your clients’/patients’ insurance? First, you need to get on the right insurance panels.

Getting on Insurance Panels

Getting credentialed (i.e., becoming an “in network” provider with an insurance company) is a technical and time-consuming process. The length of the process depends on the applicant and the requirements that each specific insurance company has determined is necessary to enroll new providers (the applications are often 30+ pages, and require a pile of supplementary information), or maintain enrollment, with their insurance networks. In general, Employee Assistant Programs (EAPs) tend to take the least amount of time-sometimes only a few weeks-while government run insurance programs like Medicaid and Medicare take the most time to complete (four months or more). As for providers, physicians customarily take a little longer to credential compared to mid-level providers like mental health counselors. One’s licensure, completion of residency programs, board certification, additional certifications, specialties, liability claims, association memberships, references, proof of education, and many other factors can effect the length and complexity of the enrollment process.

Sound overwhelming? Don’t worry, we’ve seen it all.

Doctors / MDs

Psychiatrists

Therapists / Psychologists

Professional Counselors

Physicians / Doctors

Hospitals / Facilities

Physical Therapist (PT)

Speech Pathologists

Orthodontist

DME Companies

Chiropractors

Facility Credentialing

Clinical Labs

Dentists/ Orthodontists

Optometrists

and MANY more

Insurance Credentialing is the process of becoming affiliated with insurance companies so that you (the medical/healthcare provider) can accept third autism credentialing party reimbursement. Do your patients or clients demand you accept their Aetna, Cigna, or some other insurance plan? You’re not alone. As more people have health insurance than ever before, and as people are paying more than ever before for their health insurance, you better believe they want to use it! These days, getting on insurance panels is critical for the health and success of medical practices big and small-from the solo counseling practice to the large DME company or hospital.

Getting on Insurance Panels: Getting Help or D.I.Y.?

While we’ve credentialed thousands of providers since 2008, we don’t hide behind any “secret knowledge.” If you’re just looking for some tips and guidance for doing your own medical credentialing, we have you covered. On this website, you’ll find a trove of articles and videos to help get you started and guide you through the paperwork process.

Being meticulous when completing the applications

Make copies and document everything

Follow up frequently with insurance plans to navigate any delays or problems with your application.

It’s tedious. It’s a lengthy process. The applications are long (very long), and you’ll perhaps find yourself on the phone, on hold, with some insurance companies to try to figure out why they can’t locate that application you faxed in two weeks ago-but you can do it! Some providers take the process in stride. Others would rather focus on clinical care and have us handle the process for them.

While important for the success of a clinical practice, healthcare providers often perceive the credentialing process (understandably) as an unwelcome distraction from the provider’s job (and focus) of providing quality care to patients-but it doesn’t need to be!

Let us help you. We have helped thousands of providers and practices get on insurance panels, and we want to help you next.

Call us: 855-664-5154

Affordable: One Last Thing

What will this cost? Give us a call and we can quote you a price in less than 5 minutes. We’re not trying to be elusive, it’s just that the price depends somewhat on exactly what you need.

But there’s the thing. Few things in life or business really pay for themselves-and nothing almost immediately pays for it self. This does. Our prices are such that just one client or patient will more than pay for the cost of credentialing.

Did you read that?

If you turn away just one client or patient because you don’t accept his or her insurance, you would have been financially better off having us help you become an in-network provider.

And if that isn’t enough for you to drop everything and let us begin getting you on panels, consider this: Many healthcare providers find that being on major insurance panels provides a steady steam of additional clients/patients-because potential patients go right to their insurance companies’ preferred provider lists to find a provider near them!

Don’t delay. Let’s get started growing your practice.