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OUR SPECIALIZED
CREDENTIALING

CUSTOMIZED, INDIVIDUALIZED, SPECIALIZED

PROVIDER, GROUP & FACILITY

CREDENTIALING

We Do All the Work Quickly, Effectively & Successfully!​

Checklist Preparation Items:

  • Obtain Your Business Entity Under Which to Practice (LLC, S-Corp, PC)

  • Obtain Your Tax ID & EIN from the IRS with Matching Company Info 

  • Obtain Your Professional Liability Insurance Policy 1m/3m for 2023

  • Obtain Your NPI Type I for Providers & Type 2 for Groups & Facilities

  • Obtain Your Physical Inspected & Cleared Medical Office or Facility

  • Obtain Your CAQH Profile Keep it Current with Your Current Creds

  • Obtain Your Cleared License In the State You Wish to Provide Services

  • Obtain Your DEA Authority in the Same State as You are Licensed

  • Obtain Your List of Insurance Networks You Wish to Participate In

Fill Out Spreadsheet for Our Automated Credentialing AI

 

 

 

 

 

 

 

What to Expect & What We Will Do for You!

The process is very detailed, fastidious and time consuming. Once you have prepared for the process and know which insurance companies that you want to participate with,

"It Is Time To Get Started!"

We expect to spend anywhere from 2-4 hours on each insurance carrier credentialing application when considering application preparation and numerous hours of in person phone & zoom calls for follow up throughout the entire process. This is why it makes economic sense to outsource with us in this very crucial, obligatory revenue cycle first step while you focus on treating patients and clients or work on other business development activities.

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Many providers and other healthcare practitioners starting a new practice, group or facility who previously worked for another organization often think since they are already in-network with an insurance company that little or nothing needs to be done for their new private practice.  In many situations those providers were participating under the previous organizations group taxonomies, credentials and contract which will not transfer to the new private practice.  Do not assume in these situations that your credentialing process will be any faster with the insurance companies when making these change, however, we have very good relationships with hundreds of national, local and state insurance company executives where we have direct access to the decision makers of your credentialing approval process and participating provider status.

 

We will contact each plan of your choice to determine your contract status and get instruction on setting up your new practice, group or facility. Some carriers will require you to go through the entire process from the beginning, others may have abbreviated processes to get a new private practice contract issued.  If you were participating with the previous organization under an individual contract, then you may be able to transfer your contract to your new private practice.  The process varies widely by plan, and we will sort all of that out for you personally. If you were participating in a network under a previous employer or organization contract, you may still receive a rejection to issue a participating provider contract if the network is not accepting new providers in your area since the contract would be a new issue for the network which we will handle for you. 

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Be aware that the credentialing process usually takes 30-90 days and, in some cases may take 120-180 days to complete IE: Medicare & Medicaid. As you may be aware, many insurance companies may not be accepting new providers on their panels. Do not worry, we will make contact and fight to bring you into the network as this is our specialty and even though networks may not be accepting new providers in your service area. In which case your options are to appeal their decision and continue to work with the carrier's ad hoc department, credentialing department and contracting department until it is completed, even in a closed panel!

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