Physician Credentialing Services for Insurance Enrollment

Credentialing enables an insurance company to verify a physician's qualifications and ensure they meet their requirements. It's one of the first steps to becoming an in-network provider with a private insurer or participating in Medicare or Medicaid.

It's also a complicated, time-consuming process that involves compiling documentation, lining up references and completing an error-free application. You can expect to fill out an application with each insurance panel you wish to join, as well as the Council for Affordable Quality Healthcare (CAQH).

Accuracy is critical to preventing delays in application processing. Working with a physician credentialing specialist ensures each step is completed accurately, thoroughly and on time. The faster you can complete the credentialing process, the sooner you'll be able to accept more patients and get reimbursed by the insurer you're enrolled with. 

Our Physician Credentialing Services

At ProMD, our credentialing experts are ready to help you streamline the entire process. We can assist with the following:

• Gathering the required documentation: You'll need to provide details on your education, background and licenses. We'll research the insurance company's requirements and timelines and help you obtain the necessary information.
• Verifying your credentials: To prevent delays, it's crucial to confirm the information you provide accurately reflects your background before sharing it with the insurer. We'll verify your credentials to ensure everything is accurate and up to date.
• Assisting with your CAQH application: You'll likely need to complete a CAQH application in conjunction with your insurer's application. We can assist you with completing the CAQH application and establishing a CAQH profile. We can also help you maintain your CAQH profile to ensure it's always current.
• Following up with insurers: Credentialing requires following up with the insurer you've applied to so you can check the status of your application and confirm there are no reasons for a delay. We'll handle follow-up calls and update you on your application status.
• Providing guidance and support: We understand that credentialing is a complex process. You can turn to our team of experts for advice and reassurance with every step. 
• Negotiating contracts: We can review contracts before you sign anything and consult you on the next steps. We can also help you determine your desired rates and consider other areas to negotiate, such as the claims submission period. We can then support you in building a strong case and presenting it to the insurer.

Whether you're joining a new insurance panel or want to renegotiate an existing contract, we can help. We're happy to tailor our services to meet your credentialing needs.

Reasons to Use a Physician Credentialing Company

Completing the credentialing process cannot be done in a few minutes. It typically requires several hours per insurer to compile the necessary documentation and complete an application. You'll also need time to follow up with insurers regularly to ensure you're on track.

A credentialing service eliminates frustrations and accelerates the process. Credentialing specialists have experience navigating complicated requirements and applications and can ensure the process is completed efficiently. Plus, working with an expert means you'll have a single point of contact rather than juggling communications with insurance representatives.

Contact ProMD to Learn More

Credentialing is an essential step in becoming an in-network provider. It can also be complicated, time-consuming and intimidating. Let us handle the process for you.

Since 2004, we've been helping health care providers reduce their administrative burden by providing all services related to revenue cycle management. Our specialists are fully based in the United States to ensure smooth, timely communications.

If you're ready to proceed with credentialing, contact us today and discover how we can help. 

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