We facilitate enrollment for individual providers and groups with CMS (Medicare & Medicaid) and commercial plans.
We assist in enrolling Facilities, Laboratories, Home Health & Adult Care Centers.
We assist providers and groups with CMS (Medicare & Medicaid) and commercial plan enrollment.
At the start of your billing cycle, we provide support by handling pre-authorizations, ensuring a comprehensive billing process.
We help new Providers and Practices get licensed and certified in multiple states.
We assist providers and groups in obtaining NPIs to initiate credentialing /contracting.
At CredentialFied, we specialize in delivering top-tier medical billing and insurance credentialing services tailored to the unique needs of healthcare providers across the USA. With a focus on accuracy, speed, and reliability, we help practices thrive by simplifying complex processes and boosting operational efficiency.
Their billing accuracy and follow-up are unmatched. Our claims rejection rate dropped significantly, and we saw noticeable improvements in revenue within just the first quarter. CredentialFied is now an extension of our internal team.
We were drowning in credentialing paperwork and delayed insurance approvals. CredentialFied streamlined the entire process — from enrollments to re-validations - and kept us in full compliance. Their expertise has saved us time, money, and a lot of headaches.
CredentialFied completely transformed our practice’s credentialing process. What used to take us months is now done efficiently and with zero stress. Their team is highly knowledgeable and responsive — we saw a 25% faster onboarding for our providers.
Medical credentialing is essential because it verifies the qualifications, experience, and professional standing of healthcare providers. This process ensures that practitioners meet industry standards and are capable of delivering high-quality patient care.
Credentialing protects patients by maintaining a high level of care and safety, while also helping healthcare organizations avoid legal issues and ensure compliance with regulations. Additionally, it facilitates smooth interactions with insurance companies, enabling providers to be reimbursed for their services.
Common challenges include managing complex and time-consuming verification processes, maintaining up-to-date records, and ensuring compliance with regulatory standards.
The expected duration of the provider credentialing process can vary depending on various factors, such as the complexity of the application, the number of providers being credentialed, and the responsiveness of third-party organizations involved in the process. However, on average, the provider credentialing process can take anywhere from 60 to 90 to even 120 days. Outsourcing to a reliable service provider can shorten the duration of the process efficiently and effectively.
Professional credentialing services help maintain provider networks by ensuring that all providers meet required standards, facilitating enrollments, and managing ongoing compliance to avoid disruptions in care delivery.
Credentialing services help maintain provider networks by ensuring that all providers meet required standards, facilitating enrollments, and managing ongoing compliance to avoid disruptions in care delivery.
Yes, having a service location is a crucial component of the credentialing. Insurance companies typically require providers to have a physical service location where they deliver healthcare services. This is where patients can contact the provider and show the provider’s presence in the community.
When you start the credentialing applications, you must give information about where you work, like the address and contact details. The insurance companies use this information to verify your eligibility and to ensure that you are accessible to patients seeking healthcare services. Having a well-defined service location is, therefore, an essential prerequisite for starting the credentialing journey.
Sometimes people tend to use illegal ways of obtaining degree certificates so that they can carry unlawful work without getting caught. Utilizing fake degrees from colleges or universities, fraud work experience certification, fraud license, lying in resumes to get employment are some examples. There were multiple scenarios where some people have provided medical care and performed surgeries despite no real qualifications. This carries a significant liability risk on the health care organization. Due to these reasons many health care organizations make it their policy never to employ a provider or physician without appropriate credentialing via primary source verification.