Medical Credentialing Services
Get Credentialed & Enrolled, Faster and Easier !
Med Revolve Billing – a best medical billing agency – is a top-rated Medical Credentialing Service Provider. Our Outsourced Credentialing Services eliminate administrative burdens while also unlocking privileges, ensuring in-network integration, and accelerating reimbursements. We empower doctors, nurses, and therapists to thrive in their careers. Join the ranks of satisfied practitioners via our Doctor Credentialing and Enrollment Services.
- Providers receive timely payment.
- Patients are accurately billed for services.
- Payers accept claims without rejection.
1st Class Reimbursement
Enjoy the advantage of first-preference reimbursement rates, maximizing your financial rewards. This means you get paid more for the same services, increasing your profitability and satisfaction.
Maximum Privileges
Our streamlined approach not only wins you contracts but also secures vital privileges. You will be able to participate in innovative programs, as well as get incentives for quality performance.
Billing-Ready
You’ll be prepared to bill from day one, saving you precious time. You will receive a unique provider identification number (PIN) that allows you to submit claims electronically and track them online
Swift Reimbursement
Faster reimbursements ensure a healthy cash flow for your practice. You won’t have to wait for months to receive your payments, as we process claims within 15 to 30 days on average.
Payer Support
Our advocacy ensures insurance companies stand by you, supporting your needs. We negotiate on your behalf and resolve any issues that may arise, ensuring you get paid fairly and promptly.
Minimize Denials
With our expertise, denials become a thing of the past, boosting your efficiency. We verify eligibility, obtain authorizations, and submit accurate claims, reducing errors and rejections.
Med Revolve Billing’s Provider Credentialing Services
Enrolling Providers with Premium Payer Networks!
Credentialing, also known as insurance credentialing or doctor credentialing, is a process that verifies the qualifications, skills, and legitimacy of a healthcare provider. This process ensures that the provider has the necessary licenses, certifications, and education to provide healthcare services to patients.
Only a credentialing provider is eligible to receive payments from the payer and work in compliance with the state and federal regulations. Medical credentialing authorizes physicians to practice in a specific facility and be included in insurance networks like CMS/Medicare, Medicaid, Aetna, Cigna, Humana, UnitedHealthcare, and Blue Cross Blue Shield.
As a provider, you want fast credentialing services so as to start practicing and billing (legally and ethically). However credentialing is a complex process that involves a lot of documentation and verification at different stages by the insurance network. This means a single mistake can result in denials and wastage of resources such as time and money.
Med Revolve Billing’s – a best medical billing agency – medical billing company offers the best healthcare credentialing solutions. Our professionals handle all the tasks for you, from primary source verification to enrollment in premium payer networks. We do all of this in minimal time and budget.
Are You Frustrated with Medical Coding Errors, Denials, and Delays?
Med Revolve – a best medical Billing agency- provides complete medical coding solutions and services. Our certified coders handle all coding projects — in patient, outpatient, emergency, or specialty services. So don’t let medical coding problems affect your bottom line, as our experts will detect them and correct them before they damage your practice.
Medical Credentialing Process
A Way to Our Provider Credentialing Process
Med Revolve Biling’s – a best medical billing agency – provider credentialing process is not just a routine procedure, but a validated and certified process that ensures the highest standards of compliance. We have achieved up to a 98% success rate in getting providers approved in premium payer networks with maximum privileges in their specific specialties. The process typically includes the following steps:
Surveying the provider
Our credentialing process begins with an in-depth survey conducted by our credentialing specialists. This process involves comprehensive interviews with providers, gathering essential data such as license numbers, pulvinar educational history, demographics, and professional background.
Choosing the insurance company
Our medical credentialing services guide providers in strategically choosing insurance partners aligned with their practice goals and license type, while also finalizing insurance panels based on practice location.
CAQH Enrollment and Management
We take care of CAQH application submissions, manage ProView accounts, and keep credentials current for smooth primary source verification. We also assist with payer credentialing submissions, ensuring quick insurance panel integration and accurate profiles that enhance network engagement and the quality of patient care.
Ensure Fast Credentialing Approval
Although the typical timeline is 60-120 days, our provider credentialing experts take proactive steps to accelerate the process. Our team engages in weekly interactions with payers, advocating for the rapid processing and endorsement of your credentialing applications.
In-Network Enrollment
Upon completing credentialing, your application enters the contract phase. Here, an in-network contract may be offered, including fee schedules and eligible CPT billing codes. We handle closed panel challenges, advocating through appeals to secure your inclusion. With successful credentialing, direct billing becomes feasible, often demographics, and professional background.
Winning you Hospital Privileges Application
As credentialing wraps up, our active involvement persists. We assist you in gaining all necessary hospital privileges: whether it’s admitting, courtesy, or surgical rights.
Ongoing Monitoring and Updates
Our continuous oversight ensures that your company’s credentials remain current and that you stay credentialed without interruption. Our experts diligently track your credentialing expirations and conduct comprehensive daily and weekly reviews to maintain your active status. You can rest easy knowing that your credentials are in good hands with us.
Provider Cedentialing Solutions
Helping Providers With Their Credentialing Issues
Med Revolve Billing – a best medical billing agency – credentialing company offers all-inclusive provider credentialing services for healthcare professionals and organizations. Here’s an overview of the medical credentialing and enrollment services we provide:
Medicare and Medicad Provider Enrollment
We enroll providers in Medicare and Medicaid programs, which are the largest health insurance programs in the US, covering millions of Americans. By enrolling in these programs, providers can expand their patient base, increase their revenue, and comply with federal and state regulations
Commercial Insurance Credentialing
We credential providers with commercial insurance payers like Aetna and Humana, which are private health insurers that offer different plans and networks for their members. By credentialing with these companies, providers can access more patients and negotiate better reimbursement rates.
NPI Registration (Type 1 and Type 2)
Our credentialing solutions help individual providers (Type 1) and organizations (Type 2) with obtaining and updating their National Provider Identifier (NPI), which is a unique 10-digit identification number assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS). Having an NPI is required for billing, reporting, and electronic transactions.
CAQH Registration and Maintenance
We help providers stand head and shoulders above their peers. Our credentialing specialists register and maintain every provider’s profile on the Council for Affordable Quality Healthcare (CAQH) ProView, which is an online database that collects and verifies provider information for credentialing purposes. By using CAQH ProView, providers can refine their credentialing process with multiple health plans.
MCR DMEPOS Enrollment
Providers using our credentialing service can enroll in the Medicare DMEPOS program, which covers items such as wheelchairs, oxygen equipment, braces, and diabetic supplies. By enrolling in this program, providers can offer these items to Medicare beneficiaries, improve their quality of care, and receive reimbursement from Medicare.
Hospital Privileges
We facilitate physicians with obtaining and renewing their hospital privileges, which are the rights and responsibilities granted by a hospital to a provider to practice within its facilities. By having hospital privileges, providers can admit and treat patients, access hospital resources, and collaborate with other health care professionals.
Enrollment and Credentialing
Payer Enrollment Services For Healthcare Organizations
Proper credentialing is essential for healthcare providers to deliver quality care, attract patients, and maintain compliance. Our comprehensive credentialing service helps providers of all specialties navigate these challenges. Our payer enrollment credentialing services are available for:
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Physicians
Our credentialing service ensures physicians gain swift access to insurance networks, accelerating patient care. It’s crucial for maintaining credibility and trust with patients and peers.
PAs/NPs
Credentialing via our service aids PAs/NPs in expanding their practice reach, ensuring they’re authorized to deliver essential medical services independently.
Hospitals
Credentialing with us streamlines hospital operations, enabling efficient insurance claims processing and fostering collaboration among medical staff.
PT/OT/SLP
Our credentialing services facilitate therapists’ inclusion in insurance panels, enabling them to offer vital rehabilitation services while maintaining financial stability
Podiatrists (DPM)
Credentialing through us empowers podiatrists to offer specialized foot care, securing their position as recognized experts in their field.
Chiropractors (DC)
Our credentialing service solidifies chiropractors’ standing in the medical community, granting them access to insurance networks for widespread patient engagement.
Ambulatory Surgery Centers (ASC)
Credentialing via our service for ASCs enhances patient trust by demonstrating adherence to rigorous quality standards, crucial for safe surgical procedures.
Urgent Care Facilities
Our credentialing services ensures urgent care facilities are in-network with insurers, making prompt and affordable medical services accessible to a broader range of patients.
Diagnostic Testing Facilities
Credentialing helps diagnostic facilities and clinical laboratories gain insurance approval, increasing patient referrals and enabling prompt diagnosis and treatment.
Ambulatory Surgery Centers (ASC)
Credentialing via our service for ASCs enhances patient trust by demonstrating adherence to rigorous quality standards, crucial for safe surgical procedures.
Ambulatory Surgery Centers (ASC)
Credentialing via our service for ASCs enhances patient trust by demonstrating adherence to rigorous quality standards, crucial for safe surgical procedures.