Credentialing & Physician Contracting Services

The Story Unfolds...

Health Tech Billing Solutions offers indispensable credentialing and physician contracting services to healthcare providers, ensuring compliance with insurance carrier requirements and uninterrupted service delivery to patients. We comprehend the intricacies of the credentialing process, with a team of experts deeply familiar with insurance carrier and regulatory demands, and established relationships with major healthcare carriers. This expertise enables us to efficiently navigate the credentialing and physician contracting journey, guaranteeing top-tier service and results for our valued clients.

Contracting & Pricing

We recognize the intricate nature of managing contracting and pricing for your healthcare practice. Our dedicated team of professionals not only possesses in-depth knowledge of the provider credentialing process but also stays abreast of the ever-evolving industry landscape and payer requirements, ensuring a streamlined and stress-free experience. We take the burden off your staff by assuming full responsibility for the contracting process, from start to finish. Our comprehensive service includes gathering all required documents, managing the credentialing process, submitting applications to payers, and promptly addressing any requests for corrections or additional information from payers. Furthermore, we understand the critical importance of meeting re-credentialing deadlines. To this end, we assign a dedicated team of experts to track these deadlines and initiate the re-credentialing process when your practice is due for renewal. We collaborate closely with your organization, handling the initial application, conducting background checks, and ensuring that all necessary steps are taken to secure timely approval for your providers. With Health Tech Billing Solutions, you can trust that your credentialing and contracting needs are in capable hands, allowing you to focus on your core responsibilities.

Competitive Rates and Flexibility

Recognizing the significance of cost efficiency, we take pride in offering services at rates that undercut our closest competitors and other staffing agencies. Our competitive pricing encompasses a comprehensive range of credentialing services, encompassing the collection, meticulous auditing, and efficient uploading of all essential documentation. This includes resumes, licenses, immunity records, certifications, and diplomas, ensuring a seamless and cost-effective solution tailored to your distinct requirements.

Expert Workforce

Our accomplished team of experts boasts a wealth of experience in every facet of the credentialing process. From obtaining vital documents and rectifying missing information to conducting meticulous site visits and adhering to stringent policies and procedures, our team ensures a seamless credentialing journey. We take pride in our agile workforce, equipped with extensive knowledge in verifying medical records, including drug screens and background checks, all contributing to the delivery of high-quality and comprehensive services that meet your credentialing needs with precision and efficiency.

Proactive Credentialing Services

Recognizing the pivotal role of CAQH in the credentialing process for most insurers, we are committed to supporting you in every aspect of CAQH management. Our services encompass creating, updating, and maintaining your CAQH profile to ensure it remains current and accurate. Additionally, we offer a transparent status tracking dashboard, enhancing visibility into your credentialing application status. This invaluable tool not only streamlines the process but also provides the motivation needed to expedite your credentialing journey, ultimately saving you time and resources.

24 / 7 Compliance

Our services are truly global, we operate around the clock. We take compliance seriously, ensuring 100% adherence to the Affordable Care Act, Medicare, HIPAA, and Medicaid. Staying on the cutting edge of municipal, state, and federal guidelines, we continuously refine our processes to maintain the utmost accuracy and organization of your records. By eliminating the need to submit redundant information for the same physician, we not only ensure efficiency but also save valuable time, allowing you to focus on providing top-notch healthcare services.

Physician Credentialing Process

Initial Consultation

We initiate with an initial consultation to understand your practice’s unique needs, enabling us to develop a customized credentialing plan tailored precisely to your requirements.

Data Collection

Our team of experts collaborates closely with your organization to collect all essential information and documents crucial for the credentialing process. This encompasses the verification of education, training, licensure, work history, and malpractice insurance, ensuring a comprehensive and accurate credentialing process for your practice.

Application Completion

Upon gathering all requisite information, we take charge of completing and submitting your application to the relevant payer. Our meticulous team guarantees the application’s completeness, accuracy, and full compliance with all necessary requirements, assuring a seamless credentialing process for your practice.

Follow Up Insurances

Our dedicated team takes charge of monitoring the application’s progress and maintains proactive communication with the payer to secure timely approvals. We promptly address any requests for additional information or corrections, prioritizing an expedited credentialing process to minimize disruptions for your practice.

Re-Credentialing

Recognizing the significance of re-credentialing deadlines, we deploy a dedicated team of experts to meticulously track and initiate the process as your practice’s due date approaches. Our collaboration extends to assisting with initial application completion, conducting thorough background checks, and ensuring all requisite steps are taken to secure timely approvals for your providers, guaranteeing the seamless continuation of your practice’s operations.

CAQH Enrollment

We offer invaluable assistance to providers in enrolling for CAQH and diligently maintaining and updating their profiles. This commitment to streamlining enrollment processes and maintaining accurate records ensures that you remain consistently compliant with the latest regulations, allowing you to navigate the evolving healthcare landscape with confidence and ease.

Expiring Documents Alert

We recognize that credentialing is a continuous, ongoing process that demands diligent monitoring and tracking. Our comprehensive credentialing services encompass the proactive monitoring and tracking of credential renewal dates, with timely alerts to keep you informed. Our centralized file systems provide a clear overview of each physician and document approaching expiration, serving as an invaluable checklist to ensure timely document collection and maintain compliance seamlessly.

Review Contract

Upon securing approval, we undertake a meticulous review of your participating provider contract, leaving no detail unchecked. This comprehensive scan includes critical aspects such as claims submission procedures, fee schedules, and filing deadlines, ensuring absolute clarity and acceptability of all terms and conditions. Following this thorough review, we promptly deliver all copies of credentialing applications and contracts to you, providing full transparency and documentation for your peace of mind.

Ongoing Support

Our dedicated team offers continuous support to safeguard your practice’s compliance with payer requirements. Collaborating closely with your organization, we ensure that all essential updates and changes are swiftly implemented, effectively minimizing the risk of delayed payments and sustaining the financial health of your practice.

Why Proper Credentialing is Essential for the Success of Your Medical Practice

Legal and Regulatory Compliance

Ensuring proper credentialing is not just a matter of compliance; it’s a crucial safeguard against costly fines, lawsuits, and reputational damage. Medical practices must meet rigorous standards and requirements to maintain their credibility and reputation. Our credentialing services serve as a vital shield, helping practices navigate the complex landscape of legal and regulatory compliance, safeguarding them from potential issues and preserving their professional standing.

Patient Protection

Patient safety is paramount in healthcare, and proper credentialing is a linchpin in ensuring it. Through thorough verification of healthcare professionals’ qualifications, practices instill confidence in patients, assuring them of care by qualified and competent providers. This trust-building dynamic not only enhances the patient-practice relationship but can also drive increased patient referrals, reinforcing the practice’s commitment to safety and quality care.

Reputation and Credibility

In the realm of medical practice, reputation and credibility are invaluable assets. A practice that boasts comprehensive credentialing showcases its unwavering commitment to hiring skilled professionals, ultimately bolstering its standing in the healthcare community. This enhanced reputation not only attracts increased patient referrals but also contributes to greater revenue, making our physician credentialing services a vital catalyst for your practice’s ongoing success and growth.

Improved Patient Outcomes and Satisfaction

The quality of healthcare delivery is undeniably linked to the qualifications and training of professionals. Effective credentialing verifies that healthcare providers possess the essential skills and qualifications, directly translating into improved patient outcomes and heightened satisfaction. By utilizing our credentialing services, your practice can elevate patient care standards, ultimately contributing to a more successful and patient-centric healthcare practice.

Physician Credentialing Services

Health Tech Billing Solutions Credentialing Services provides a comprehensive solution for medical practices, streamlining the intricate process of verifying and documenting healthcare professionals’ qualifications. Our services are tailored to ensure compliance with legal and regulatory standards, safeguard patient well-being, boost practice reputation and credibility, and elevate patient outcomes and satisfaction. We are your trusted partner in navigating the complex world of credentialing, promoting excellence in healthcare delivery.

Medical Billing Software We Leverage for Revenue Cycle Management

FAQ

How long does physician credentialing take?

The duration of the physician credentialing process is subject to variability based on the provider, insurance entity, and other influencing factors. While the timeline can extend over several months, Health Tech Billing Solutions is dedicated to accelerating the credentialing procedure. This is achieved by proactively managing deadlines, and diligently pursuing follow-ups with insurance providers and relevant organizations to enhance the efficiency of the overall process.

How can Health Tech Billing Solutions assist with physician credentialing?

Health Tech Billing Solutions features a dedicated team of specialists with expertise in physician credentialing. Our comprehensive support covers every facet of the credentialing process, encompassing the collection and validation of requisite documentation, the thorough completion and submission of applications, and persistent follow-up with insurance providers and other entities. Our commitment lies in expediting the credentialing process, ensuring efficiency and prompt completion.

How does Health Tech Billing Solution ensure the accuracy of credentialing information?

Employing cutting-edge technology and adhering to industry-leading practices, Health Tech Billing Solutions prioritizes the precision of credentialing information. Thoroughly scrutinizing all documentation, we verify completeness and accuracy, and subsequently engage in follow-up procedures with insurance providers and other relevant organizations to affirm the correctness of the information