Medical credentialing service is the process of enrolling healthcare professionals with federal and commercial insurance agencies. It is a vital step for providers so they can give services to patients who are enrolled with those agencies.
Prime Doc Billing simplifies, manages, and speeds up the entire process for providers. Our experts guide you through the process, reducing the chances of denial.
Prime Doc Billing has expert credentialing specialists to help providers with network participation. We have a thorough understanding of accreditation standards. It enables our medical credentialing services to meet quality standards, compliance, and safety.
By choosing us, you can guarantee faster approvals, fewer delays, and a streamlined process. We do not only simplify the entire process for you, but also keep your credentials up-to-date.
The Medical Credentialing Process can be draining and time-consuming. It requires significant time and effort throughout the process. That is why we are here to handle the steps, so you can focus on patient care.
Before starting the medical credentialing process, we collect all the required documents from our client. It includes their education, training, work history, and license. Our experts make sure to double-check the documents so there's no error of incomplete documentation in the future.
Choosing the right insurance is very important for the provider’s patient population. We help you select the insurance panels that best match your needs.
Getting the right insurance can help you:
The Council for Affordable Quality Healthcare (CAQH) is a government-based centre for healthcare professionals. Insurance companies use CAQH to verify providers’ credentials before approving their participation. Having a CAQH profile is important to expand your reach and boost visibility.
Prime Doc Billing has the knowledge of specific requirements of different insurance companies which helps setting up the CAQH profile. Most companies require the providers to re-credential their information every 90 days.
We help you maintain an accurate and up-to-date CAQH profile for faster approvals and reimbursements. A well-maintained profile reflects professionalism, hence encouraging better payer relationships.
Complete documentation and regular follow-up are the keys to fast credentialing approval.
Our dedicated teams perform proactive re-credentialing so the provider stays active. This helps the process get fast credentialing approval. Often completed in weeks rather than months.
Once the provider is credentialed with insurance, they can apply for in-network enrollment.
Our dedicated team helps providers join the right insurance panels that best fit their credentials. This helps them get timely reimbursements, increasing cashflow.
Hospital privileges allow a provider to work on hospital premises and perform procedures. Prime Doc Billing’s experts help the providers get Primary Source Verification (PSV) required by law.
We take consistent follow-ups with the hospital’s office and respond to any need for documentation.
Enrollment with insurance companies begins after the credentialing process. Completing the enrollment process requires submitting documents and getting approvals. After that, a provider can submit claims and get reimbursements for their services.
Medicare refers to the insurance of patients aged 65 and above and those with certain disabilities. Medicaid insurance covers patients with limited income and resources. Providers must enroll with both types of federal health insurance to get reimbursements.
Prime Doc Billing helps you enroll in these networks by filling out paperwork. We also perform other processes like license verification, background checks, and registering for a National Provider Identification (NPI) number.
We track the status of your application and fix any rejections with the help of credentialing software.
Commercial Insurance Credentialing allows providers to work with private insurance to get reimbursements.
Prime Doc Billing helps you be an in-network provider to broaden the type of patients you can treat. From handling paperwork to automated reminders, we are here at your service.
We understand the unique requirements of specialties as they vary in the credentialing process. We offer credentialing for all kinds of specialties in all the states of the USA. Some of them are mentioned below:
We perform Physician Credentialing by verifying the physicians’ medical school, residency, and license. They must also have continuing medical education (CME) to stay updated with the latest medical practices.
Physical Therapists are required to have a Doctor of Physical Therapy (DPT) degree. We check if PT has graduated from a CAPTE-accredited program and has proof of work history.
An OT must have a National Board for Certification in Occupational Therapy (NBCOT) certificate. We start by gathering all essential documents. And then complete the necessary forms for validation.
Speech-Language Pathologists (SLPs) are required to own a Certificate of Clinical Competence (CCC). Prime Doc Billing knows every required document and credentialing process.
Prime Doc Billing verifies whether the ASC has
We handle documents, identify gaps, track records, and rework applications if needed.
They are non-physician providers; hence, we can find them in retail locations as well. Prime Doc Billing guides them through vision and hearing-specific insurance panels. We also ensure NPI registration for a smooth credentialing process.
Our team helps Physician Assistants and Nurse Practitioners keep their CAQH profiles updated. We also check their work history, license, and supervisor physician info for credentialing.
Podiatrists are foot and ankle specialists. Our experts handle their Medicare and Medicaid enrollment with separate forms. They use equipment like diabetic shoes and ankle braces, so we help them enroll as suppliers.
Since they work in a group, we help them get Type 2 NPI. Our experts also check their licenses and documentation to prevent future denials.
They are the fastest-growing practitioners who need both types of NPI. Prime Doc Billing helps them get approved for telehealth billing, which requires the verification of multi-state licenses and a compliance guide.
Prime Doc Billing helps them with
We provide them with a medicare documentation audit to reduce the chances of denial.
Diagnostic Testing Facilities must credential themselves with insurance companies so they get reimbursements for tests and Xrays. We help them with
We possess the understanding of the state, federal, and private insurance company policies. We stay up-to-date with their regulations to ensure compliance and cut delays.
We have handled many complex cases with a proven track record. That makes us one of the best medical billing credentialing options in the industry. And the trusted choice for your healthcare practice.
Here at Prime Doc Billing, we take care of credentialing so you can focus on patient care. Our fast and accurate credentialing can help your practice get proper reimbursements.
No matter what your specialty is, our team can guide you through every step of the way. Connect with us now!
(347) 650-2656
(347) 650-2656
info@primedocbilling.com
