What is the process for credentialing?
There are several phases of the credentialing process, and we are willing to help you with as many or as few of them as possible. Here is how we categorize the process:
1. Preparation: Gathering information about the provider to begin the credentialing process
2. Selection: Selecting which insurance companies to credential with from the list below
3. Contact: Creating a contact person with the insurance companies for submitting documents
4. Initial Submission: Sending over necessary paperwork for credentialing to each of the insurance companies discussed
5. Subsequent Submissions: Sending additional requested documents, clarifications, etc, to the insurance company as they request them.
6. Follow Up: Calling each contact at 30, 60, and 90 days to ensure the process is still in progress, and making sure no additional information is needed.
7. Finalizing: Finalizing all contacts, creating a document of passwords, website and portal logins, and a PDF copy of all documentation provided along the way
8. Re-Credentialing: Many insurance companies require you to renew your information annually, or in set intervals. If you have already credentialed, and need help completing the re-credentialing process, please make sure to provide the requests from the insurance companies.
9. Investigations: If you’ve started your credentialing yourself, and are not certain where things are at, and what else needs done, this category is for you. Let us take over and get you back on track.
10. Re-Organizing: Sometimes, providers are not certain of their networks, due to various circumstances. Re-Organizing is for locating network status amongst most payers, and gathering copies of contracts, fee schedules, and other forms that may be helpful in streamlining your billing process.