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Credentialing – The Key To The Castle

Credentialing is the lynchpin to reimbursement from any insurance provider. Before you submit any claims for your new practice, or if you want to continue submitting insurance claims – you must have your providers credentialed.

If you fail to keep your providers up to date with their credentials and the management of that information will inevitably lead to a loss of revenue and endless headaches. As an independent practice, managing the details of credentialing can be tedious and time consuming. Whether you’re filling out application after application, gathering documentation or waiting on hold with payers and their representatives, your time is too valuable to spend doing all of this.

While many medical billing companies will say they can handle your credentialing needs, Medical Claims Billing has a team dedicated to the credentialing of our providers. Our extensive experience with credentialing requirements, combined with the attention to detail and management of your account ensure that no claims get missed or denied due to a non-credentialed provider. Here’s how we can help:

If You’re A New Provider

You might be ready and eager to see your first patient, but hold your horses. If you plan to accept insurance, you must credential with most insurance companies to receive reimbursement. We will help you credentialing and contract with the insurance companies of your choice.

If You’re Starting a New Practice

Perhaps you were previously credentialed under a different medical group or you’re in a new state and have to meet different requirements. Changing your tax ID could require that you obtain credentials from all of your insurance providers.

Are You Adding New Providers

Great news! Your practice is doing well and you need to add providers. Some insurance companies will require group contracts for practices with more than one provider. Each provider will need to be credentialed and either added to the group contract, or have an individual contact that will pay to the practice tax ID. Medical Claims Billing is there to help make that happen.

New Insurance Payer

If you’re looking to accept new insurance plans, we can not only help you with the enrollment, but we can also review reimbursement from similar specialties and see which plans might make the best fit for your business.