We provide credentialing services for healthcare providers so they can bill health plans and receive in-network reimbursement. Proper credentialing helps to broaden your reach to potential patients and improves accessibility to your practice.
How The Credentialing Process Works
The credentialing process begins with determining which insurances, HMOs and PPOs are the most widely used in your area. We then work with you to apply for in-network status. We can share this responsibility with you or we can completely handle this process on your behalf. We can help with the following:
Apply to obtain an NPI
Determine your eligibility to apply for in-network status with various insurance, HMOs and PPOs.
Obtain the required paperwork in order to apply
Complete on-line applications including CAQH and other credentialing organizations
Track the status of applications supplying missing information as needed
Complete re-credentialing paperwork as needed by insurances, HMOs and PPOs
Further Considerations
- Some forms will only be able to be filled out by you. These will be forwarded to you promptly for completion.
- Most forms will require your signature. We will forward these to you for you to sign. You must return the original form and not a photocopy.
- Occasionally, insurance, HMO, and PPO panels are closed or do not accept a particular applicant. We are unable to guarantee acceptance into any particular panel and you may incur charges to Advanced Medical Billing regardless if your application is accepted or not.
- We will require several documents and information from you to complete this process. We will inform you of what is required. The successful completion of this process relies on receiving the necessary documentation from your office in a timely manner.
- The credentialing process can often take an extended amount of time. It is not unusual for many insurances to take as long as 6 months before approving a provider and allowing them to see patients.
Pricing
Our credentialing services are billed at a fixed rate of $250 per application excluding Medicare and Medicaid which are $300 each.
Ready to learn more?
Contact us for your complimentary consultation.
