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Credentialing Services

 

Physician Credentialing

Get your credentialing application 
accepted the first time...

 
 
 
 
 
 
 
 
 
 
 
 
Physician Credentialing is a process of formal recognition and attestation that a physician is both qualified and competent to provide services. Credentialing verifies that a physician meets standards as determined by the health care institutions by reviewing such items as the individual’s license, experience, certification, education, training, malpractice and adverse clinical occurrences, clinical judgment, and character by investigation and observation.

Why opt for physician credentialing services

Time and again new practices invest countless hours and money on office space, equipment, software and staffing only to find significant delays in getting adequate insurance reimbursements. More often than not, the problem could've been allayed by addressing the physician credentialing process early and thoroughly - creating the necessary relationships with insurance carriers. Effective physician credentialing services are the absolute necessity for better performance of the practice. Without proper enrolment, payments can be delayed or refused by the insurance carriers, even if the physician is otherwise ready and able to provide services

We at NewProvident offer physician credentialing services, being your first step to higher revenue. Our tailor made physician credentialing services facilitate your payor enrollment process when you

Begin your practice first

Change from one Practice to another

Adding New Physician to your existing group

Want to become networked Provider

Different Payor’s have their own set of forms to be filled either online or through paper applications. Time and again practices invest countless hours doing this or engage external resources at a very high cost. With effective physician credentialing services, you can save time.

Why choose NewProvident for your physician credentialing services

We at NewProvident help you by taking away all these hassles from you and also prevent delays & denials in getting your insurance reimbursements by providing complete physician credentialing services and making sure you get what is rightfully yours.

The following process is followed as part of our physician credentialing services :

Preparation of paper CMS 855 & other Managed Care applications for all Payor.

Preparation and submission of Online applications to federal and non-government carriers.

New provider affiliations and Group Contracts

Maintain and Update specific Provider information directly with carriers at frequent intervals or when requested.

Resolve enrolment issues and track Managed Care contracts

Validate information provided by Payors

Handling Provider letter of interest & enrolment transactions

Setting of Provider information in the Practice System

Obtaining Contracted fee schedules and negotiating changes

Preparation of contracting documents for scanning and Long-term storage electronically.

Prepare, maintain and monitor Managed Care Summaries that Provides Effective dates, Fee Schedule details and Group affiliation.

Monitoring Expiry dates for NYS-Registrations, DEAs, and CLIA registrations and also handling re-applications for the same.

Handling Re-Credentialing whenever required.

We ensure that your credentialing application gets the attention it deserves with our physician credentialing services. To know why physician credentialing is important, read our blog post onphysician credentialing.

Call a Consultant today for your Credentialing needs: 214-261-5558 ext. 100