Medical Credentialing Services
Take your mind off the paperwork, so you can get back to your patients.
Get in touch with an IntelliRCM agent to ease the burden of the credentialing process.
Forget the Stress of Time-Consuming Credentialing Paperwork
What is Credentialing?
Credentialing is the process of verifying that healthcare providers and organizations meet the standards required to give patients the highest quality of care. It is a necessary and crucial part of practicing medicine.
Insurance companies rely on physician credentialing to decide if and how they should pay for services rendered to their covered patients.
Because this process is critical, it requires an extraordinary amount of paperwork, information, and resources from healthcare providers. Depending on the type of credentialing you need, the process can take from a few days up to six months.
Not to mention the guidelines that vary from state to state.
The application process in itself can be lengthy, and then there are the different organizations where the forms have to be submitted. You have to know which forms go to which organization to ensure there are no delays in the process and the application can be approved.
There is also the task of following up with Credentialing Verification Organizations (CVOs) to keep the process moving along smoothly.
The credentialing process can be arduous and frustrating. But it doesn’t have to be!
By using IntelliRCM’s credentialing services, you can leave the paperwork and phone calls to our dedicated team, so you can focus on what you’re good at – patient care.
We will stay on top of the credentialing process for you. Our team of experts is experienced and will help speed the process along. Never worry about having to follow up or what kind of forms you’ll need. We handle the heavy lifting of credentialing.
Reduce Payer Denials, Keep Credentials Updated
The credentialing process isn’t a one-time thing – it’s ongoing. CVOs may require re-credentialing every 1 – 3 years. If you miss a deadline, you could put your practice at legal risk. Insurance companies can deny payment if your credentials are out of date.
IntelliRCM’s provider credentialing services ensure that all physician information will stay up to date to reduce payer denials and keep cash flow running smoothly.
What Our Credentialing Services Includes
Our credentialing services help you all the way through the credentialing process. We assist in data gathering, provider enrollment with the Coalition for Affordable Quality Healthcare (CAQH), submitting applications, following up with credentialing organizations, and re-credentialing.
Provider CAQH Enrollment
The CAQH is a key resource for finding credentialing information. Enrolling a provider in the CAQH ensures that their information is accessible to insurance providers.
Each credentialing organization may require a specific form to be approved. Speciality practices require additional applications and information. IntelliRCM ensures the right applications are submitted to the right organization.
If an organization like an insurance company needs additional information, the entire credentialing process is held up. To keep the process running smoothly, IntelliRCM handles all follow-ups to prevent delays.
As mentioned above, the re-credentialing process is crucial to maintaining cash flow. Missing a deadline means starting the credentialing process all over again. IntelliRCM prevents that by taking care of the re-credentialing process without you having to think about it.
Why Choose IntelliRCM
IntelliRCM’s dedicated team is here to provide the best credentialing services through specification and optimization.
IntelliRCM is led by industry professionals, consultants, and physicians. With over 15 years of experience in the US healthcare industry, IntelliRCM has honed in on the most effective ways to maximize revenue for your practice. We know how to get your practice and your practitioners through the credentialing process with little friction.
Specialized practices require additional paperwork. Our experience with a wide range of specialties ensures we are equipped to address your unique needs.
By using cutting-edge technology, we are able to customize our services for a wide range of specialties. In this way, your practice increases its revenue and you only pay for what you need.
Our Client’s Take on Us
Our client’s revenues have increased 2-4% by implementing our customized and competitive solutions.
Provider Credentialing FAQs
How does provider credentialing work?
You will request an application from the provider representative. The CVO will send you an application and any additional forms by email, mail, or fax. Once you’ve completed the application, you submit it to the CVO.
The CVO begins the process of gathering information and verifying it directly with the appropriate institutions. After verification is complete, the CVO makes the decision to approve or deny the application.
What is the difference between credentialing and contracting?
Credentialing is the initial verification process where you are approved or denied. Contracting is when a provider enters into a contract with an insurance provider.
What are the steps in the process of credentialing?
- Requesting an application
- Gathering necessary data
- Submitting an application
- Conducting follow-ups
- Awaiting a decision
How long does it take to get credentialed?
The process can take anywhere from a few days to six months.
What are the common credentialing issues?
Not having the right information, not having an organized workflow, a physician’s start date conflicting with the timeline of credentialing, and state compliance are some of the most common issues.
How long do you have to keep credentialing files?
It depends on the credentialing organization and the type of document.
What should you expect from your medical credentialing service provider company?
A credentialing service provider will gather all relevant information and documents. It will ensure all the appropriate documentation is there and all necessary forms and documentations are correctly completed. They will also contact insurance companies in order to start the application process. Credentialing services will stay on top of follow-ups and give status updates.
Do you offer a service to keep up the documents and insurance contracts that expire and must be renewed?
Yes, we will ensure re-credentialing services to make sure there are no payer denials because of expired credentialing.
How soon can you start?
The process should begin at least 90 days before the practice’s or a new hire’s first day to ensure your patients are getting the best care and your cash flow isn’t interrupted.