Healthcare Credentialing
Credentialing and contracting are necessary steps that private practice physicians and groups must carry out, but they can be extremely burdensome. Not only do providers need to fill out mountains of paperwork that sap their resources, but any mistakes made during the process can cost a lot of time and money. Payers may delay or outright refuse payments if they determine your practice is not properly credentialed and enrolled.
All of this adds up to significant headaches, which is why Health Revenue 360, LLC, offers healthcare provider credentialing expertise. When you choose us to be your medical credentialing company, you can take this worry off your plate and instead concentrate on doing what you do best — caring for your patients.
Why Outsource Your Credentialing and Contracting?
Although these tasks are essential to ensure that you are paid for providing care, they require a significant investment of time and focus. For example, every practice or physician must provide extensive documentation demonstrating that doctors meet all the required standards for delivering clinical care. This means providing verification for education, licensure, experience, certifications, affiliations, malpractice, any adverse clinical occurrences and training. This must be done for every insurer and must be completed on a recurring basis for renewals, re-enrollments and any changes.
Because of the complicated nature of credentialing in medical billing, it can be extremely beneficial to outsource these aspects of your operations. Our expertise in credentialing — as well as managed care medical contracting — means we can handle every aspect of these obligations. Choosing us to take care of credentialing and contracting means you will be able to devote more time and attention on your patients and their treatment. You also can be confident that our experts will ensure there are no mistakes that could hurt your ability to collect payments.
In addition, the recent passage of the No Surprises Act places new obligations on health plans. As of the start of 2022, insurers are required to verify their provider directories every 90 days, removing any providers that are unverified. This means providers must update health plans regularly and frequently to remain in compliance. With a 48-hour turnaround time for verifications, this legislation makes outsourcing credentialing all the more urgent.
Choose Health Revenue 360, LLC
At Health Revenue 360, LLC, we work closely with you to assess your specific needs before we do anything else. Our professionals can create a customized service plan that includes making all phone calls and follow-ups, submitting all applications, emailing and faxing, and ensuring that you are always up to date. Our credentialing and medical contracting service can give you peace of mind that you will be compliant and in-network with insurance companies. We work with providers across a wide range of specialties, such as:
- Cardiology
- Family Practice
- Internal Medicine
- OB/GYN
- Orthopedics
- Pain Management
- Pediatrics
- Physical Therapy
- Psychiatry/Mental Health
Ready to talk to one of our Revenue Cycle Specialists?