Credentialing is time consuming and can take away from your ability to run your business. We at Credentials Services LLC are dedicated to help all medical professionals and related professions to minimize the delays and costly mistakes that are often made when credentialing new providers. Utilizing our efficient services will assist new and growing practices to avoid many of the headaches, stacks of paperwork, and confusion that often comes with dealing with insurance companies. Trust the experts at Credentials Services to help you navigate the difficult process of provider enrollment and national medical credentialing at a reasonable cost. One of the most integral elements of running a practice is the process of credentialing, as well as the maintenance of your providers credentialed status. Without proper enrollment, payments can be delayed or refused by the insurance carriers. Haphazard and poorly maintained credentialing processes can result in many thousands of dollars in lost income. At Credentials Services we offer physician and ancillary provider Credentialing Services with a focus on customer service, efficiency and cost savings to the provider. We are dedicated to helping providers achieve more consistent revenue through efficient and comprehensive processes thereby saving your practice valuable time and resources that can now be devoted to managing your practice.
Who We Work With:
- Physicians (MD or DO)
- Physician Assistant (PA)
- Nurse Practitioner (NP)
- Physical Therapy (PT)
- Occupational Therapy (OT)
- Speech Language Pathologist (SLP)
- Podiatrists (DPM)
- Chiropractors (DC)
- Ambulatory Surgery Centers (ASC)
- Urgent Care Facilities
- Diagnostic Testing Facilities (IDTF)
- Sleep Labs
- Optometrists
- Audiologists
- Behavioral Health Providers
We assist with Payer Enrollment Credentialing Services with a variety of payers:
Commercial Insurance such as:
- Aetna
- Cigna
- Anthem
- Blue Cross Blue Shield (BCBS)
- TriCare
- Humana
- UnitedHealthcare
- Oxford
- Many More…
Governmental Payers Such As:
- Medicare
- Medicare Part B
- Medicaid
Why Physicians Need Credentialing?
Physician Credentialing is the process of payer enrollment and the validation that a physician is part of a Payer’s network and authorized to provide services to patients. Credentialing is needed to verify that the physician meets standards as determined by the Payer (insurance company) by reviewing such items as the individual’s license, experience, certification, education, training, affiliations, malpractice & adverse clinical occurrences, and clinical judgment.
When Physicians Need Credentialing?
- Starting to practice after Medical School
- Enrolling with New Payer
- Adding new provider to an existing group
- Forming a New Group
- Changing from one Practice to another
Services include:
- Applications and forms State License verification
- DEA verification
- NPI verification
- OIG exclusion list
- ABMS verification
- Background checks
- AMA profiles Delineation of Privileges(DOPs)
- Certificates of Insurance(COIs)
- ECFMG Confirmations Peer reference verification Facility verification Educational verification
