Why would someone want or need medical credentialing?
By credentialing with insurance panels, one will be able to see patients who have specific insurance plans and bill those insurance companies directly for the services he/she renders. This can greatly increase the number of patients who can access a doctor’s services.
What is the process of getting credentialed with insurance companies?
Yes. When you sign up for credentialing with us, you get to choose exactly which panels you want, and don’t want, to be credentialed with. Typically, most outpatient physician providers credential with 7-8 payers, whereas hospital based physicians (in-patient) usually credential with 10-15 payers (pretty much any patient with any insurance that comes to hospital).
How long does the medical credentialing process take?
While paper claims submission can take 90-120 days, standard electronic claims filing allows 7-21 days.
How can I track my Medical credentialing progress?
Billing Care Solutions gives access to the client to an online portal where he/she can always check the status of their project. Additionally, our credentialing specialist will reach out to the insurance providers every 2 weeks for updates. The same credentialing specialists will talk with the client by phone and can help them select the panels in their area that will be the best fit for them and their practice.
Do you follow up on unpaid claims?
Yes. Unless the default is for a legitimate reason, such as a deductible, capitation, lack of coverage or duplicate invoicing, we can reprocess the claim without requiring extra data.
Can interns / limited-license providers be medically credentialed with insurance companies?
In most cases, insurance companies are looking to network exclusively with fully licensed healthcare providers. As an intern you can typically bill through a supervising provider.
How much does medical credentialing cost?
We charge per panel, per provider that one applies to. Billing Care Solutions does not have any start up fees, hidden charges for the initial credentialing. The client only pays for the work that is being done. Our pricing does vary by the type of credentialing one needs.
What is a credentialing verification organization?
Credentials Verification Organization (CVO) Accreditation ensures a meaningful, rigorous, and fair credentialing process that protects both patients and providers from poor credentialing practices.
What is CAQH?
CAQH stands for Council of Affordable and Quality Healthcare. It is a nonprofit that was created several years ago by the private insurance panels. Most commercial payers require that one must have the CAQH profile completed before they begin the credentialing process. Panels use the CAQH to verify provider’s personal information as well as education and work history.
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