It is a process by which insurance carriers and hospitals verify the credentials of the medical provider. This includes verification of licenses, verification of malpractice insurance, verification of college degrees, and background checks to ensure that the provider is fully capable to provide services and does not have any adverse actions or convictions in his service history.
It is important for the provider to maintain his credibility with the insurance carriers and to hopefully receive a contract to participate in insurance companies’ various programs. This is critical to a medical provider due to the fact that most of us want to see a doctor in our network as it creates savings for us with our medical expenses. Most out of network benefits require us, the patient, to meet a deductible before any payments to the provider of services are made.
For smooth reimbursement of bills from insurance companies, your Healthcare enterprise – be it a hospital or a private clinic – must go through or have a rigorous credentialing process. However, doing credentialing can overload your already stretched resources as it requires careful verification of the healthcare provider’s qualifications like medical license, certifications, internship/fellowship, insurance related to malpractices, DEA/CDS Registration, criminal background check and much more.
Wouldn’t it be great if all this tedious paperwork was handled by competent and knowledgeable field experts who knew the technicalities of the Medicare industry on their tips? That’s exactly what we do at Baruch Business Solutions through our credentialing services.
At BBS, we ensure that every single detail of your medical qualification is noted and accurately filed so that your credentialing process is completed without any hiccups. Assisting you on the CAQH Universal Provider Datasource, our credentialing team is well aware of the extreme complexities, constant follow-ups, and inputs that are required in the credentialing process. It takes weeks, or even months, to get credentialing done so kick start your process now as what was a choice before has now become almost mandatory.
As a hospital or a private physician, one must know that insurance firms reimburse in-network providers quicker and with less out of the pocket expenses – this leads to rise in crucial revenues and profits. Why lose revenue by being an out-of-network provider when you can reap all the benefits of a large carrier network? There is more to it as credentialing is not a one-time affair and has to be cyclically done every few years which involves the same complex procedures. Trained professionals at Baruch Business Solutions understand this and provide customized support to your healthcare enterprise to traverse through the winding maze of credentialing.
Don’t get bogged down due to the elaborate nature of the process of credentialing as we will make it easy for you. Generally, due to complexities of the forms, many fields are sometimes left blank or unintended information is provided – results are the rejection of the application. As healthcare professionals or facilities this can be overbearing, and exhausting, be it at the individual level or a large facility as the staff will be occupied with unnecessary paperwork that could have been avoided.
Once credentialed, you as a private practitioner or a hospital are looked upon by insurance companies as authentic, genuine, and qualified Medicare providers. There is no reason why you would want to delay this process which boosts your efficiency and profits.