Payer Credentialing or provider enrollment is a process of asking for a participation in a medical insurance network as a Participating Provider. The process itself includes requesting a contract with an insurance company, completing the payer credentialing application, submitting licenses and other documents to the insurers and every other thing that the insurance company requires from a medical practitioner in order to sign a contract with him.
Many of the insurance companies require that a medical provider/requester has a fully completed and up to date profile at CAQH so they can obtain valid information about the provider. Policies of insurance companies differ somewhat when it comes to credentialing process.
Some insurance companies need as much as seven months to complete the credentialing process and sign a contract with the medical providers while others need three months at most.
It is particularly important for healthcare providers to thoroughly document the entire process of the application using certified mail, fax logs and documenting communication with the agents over the phone.
Outsourcing of the process of payer credentialing to specialized companies for medical management has become a general practice of medical providers.
How Can Our Service Help You
Our company for medical management services with over more than 20 years of experience in the field can provide you with the following services regarding payer credentialing:
- Data collection
- Our experts will instruct your administrative workers in the process of collecting the necessary demographics and background information.
- Application to CAQH
- We will submit the application to CAQH for those providers who need it.
- Submission of the application
- After we collect all necessary data, we will submit it in your name to the payer.
- We manage all communication with payer
Why Choose Midwest Revenue Cycle Management?
Our company led by experts in medical management strives for perfectness when it comes to fulfilling and accomplishing all administrative work related to your medical practice.
As is the case with other areas of medical management, we give our best in the field of medical credentialing and verification of payers.
We are very efficient and flexible as our expert team is combining the services to make your private practice grow and become recognized on the market of medical services.