Physician Credentialing Services

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Physician Credentialing

Each time you bring a new physician on board, you are tasked with the responsibility of reviewing their qualifications and previous work history to ensure they align with the standards put forward by regulatory and accreditation organizations. This can be highly time-consuming. What’s more, proper credentialing for doctors is also essential for revenue production and management. As a result, any errors in enrolment can directly affect your revenue cycle in the form of delayed or rejected payments by medical insurance providers.

The good news? With NAHL’s physician credentialing and medical provider enrolment services or healthcare credentialing services , you can hand over the medical credentialing process to a team of experts and let them take care of it for you. Our physician credentialing services involve enrolling and attesting a physician and making sure they are:

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We also ensure that your doctors abide by the Payer’s standards. This can be done by reviewing their:

Medical license
Experience in healthcare
Certifications
Educational qualifications
Training
Affiliations
History of malpractice and adverse clinical occurrences
Clinical judgment

Whether a physician is starting their first practice after finishing medical school, changing jobs, signing up with an existing group, or looking to enroll with a new Payer, we can take care of it. Different Payers also have different requirements, which is why our physician credentialing specialists tailor their approach to suit a specific Payer.

Our physician credentialing workflow comprises the following steps:

Option A for steps as per client’s brief –

Handing the provider with a letter of interest and requesting an application from the Payer.
Managing new provider affiliations and group credentialing to improve efficiency.
Facility credentialing – this involves adding the provider to the facility’s ID.
Preparing paper CMS 855 and other Managed Care applications for all Payers (This includes DME and Dental Payers, as well).
Preparing and submitting the online application to federal, state, and commercial carriers.
Maintaining and updating specific Provider information by contacting the carriers at frequent intervals or as required.
Resolving any errors and issues that occur during the enrolment process and tracking Managed Care contracts.
Preparing contract documents to scan and store them electronically on a long-term basis.
Preparing, maintaining, and monitoring
Managed Care summaries for the provision of necessary information such as effective dates, payment schedules, and group affiliation.

Option B for steps as per client’s brief –

Data Collection – Our physician credentialing specialists will get in touch with your physicians and collect the information required to file credentialing applications.
Establishing a Strategy – In the next step, we will develop a suitable credentialing strategy based on the selection of top Payers that your practice can send claims to.
Auditing – Each credentialing application will be reviewed and audited for inaccuracies and incomplete information.
Submission of application – Our team will proceed to submit the credentialing forms to the insurance carriers that have been selected by the physician or recommended by NAHL.
Follow-up – Post submission, our team will conduct regular follow-ups with insurance carriers to track the application’s status and manage any delays.
Receiving the Enrollment number – Once an application has been approved, the insurance carrier will provide our team with an enrollment number. We will communicate this to the physicians and scan and store this information securely for you for future use.

At NAHL, we are committed to providing you with error-free physician/provider credentialing services that improve the overall performance of your practice and grow your revenues. Our team of physician credentialing specialists strives to make sure your credentialing application is processed quickly and efficiently. Our services are competitively priced and you can expect to pay $2,000 – $5,000 annually. The initial setup cost is between $200 and $800 and you can expect to pay around $100 per application.

Physician Credentialing Services

We are the best Medical Billing Specialist in US