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Provider Credentialing and Contracting

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Provider Credentialing and Contracting

Time is money, and nowhere is that as apparent as when you are working through provider credentialing. This time-consuming and painful process is required throughout the healthcare industry, yet can be a major bottleneck unless your processes are optimized.

Provider credentialing is critically important, and our credentialing specialists will work with you every step to of the way to ensure that you are always up to date with the status of your credentialing process. While the entire process can take from 90-270 days, during which time you should not accept patients who have an insurance that has not fully credentialed as insurance will not backdate effective dates. There are some leniencies with Medicare and Medicaid, but these depend on the state in which your practice resides.

Once your application is processed and approved, our credentialing specialist will contact you with effective dates and a Provider ID#.

We also provide the following services on an ongoing basis for your peace of mind:

  • Maintain all credentialing documents (State License, CDS, DEA, Malpractice insurance, Board Certificate, etc.)

  • Update documents to provider’s CAQH profile and re-attest at regular intervals.

  • Track and provide notification of expiring documents like license, CDS, DEA and more

  • Re-credential and re-validate providers with insurance companies on an as-needed basis

  • Renegotiate the existing contracts with insurance companies to get better rates