Credentialing
START EARLY
Begin credentialing at least 120 days before seeing patients to avoid delays in reimbursement.
BE ELABORATE
Take the time to complete paperwork accurately; even small errors can result in weeks of delays.
CONSISTENCY
Regularly follow up with payers to ensure the status of your applications stays on track.
DELEGATE
Trust the credentialing experts at CareCents to handle the process, ensuring timely and accurate results.
Credentialing Services
Credentialing is an essential process in the healthcare industry, ensuring that medical professionals are qualified to deliver high-quality care. At CareCents, our credentialing services are designed to simplify this complex process, enabling healthcare providers to focus on their patients. From initial verification to ongoing monitoring, we handle every step with precision.
Our credentialing team thoroughly evaluates healthcare providers’ education, licensure, training, and professional background. This process ensures that only qualified professionals are authorized to practice. Below are the key components of our credentialing services:
Verification of Education and Training
We confirm the educational credentials of healthcare providers, including medical degrees, residency programs, and specialized training. This verification guarantees that providers meet the educational standards required for their field of practice.
Active Licensure Validation
CareCents ensures that all licenses are active, valid, and compliant with state and federal regulations. Our team works directly with licensing authorities to ensure a seamless and error-free verification process.
Professional History and References
We investigate employment history, clinical expertise, and references from peers or supervisors. These insights help us assess the provider’s professional performance and ethical standards.
Background Check and Malpractice Review
Our credentialing services include a comprehensive review of malpractice history and legal records. This ensures the safety of patients and protects the reputation of healthcare facilities.
Board Certification Confirmation
For specialists, we verify board certifications to confirm their advanced expertise in specific medical fields. This adds an additional layer of credibility to their qualifications
Ongoing Monitoring and Updates
Credentialing doesn’t end after initial approval. CareCents provides continuous monitoring and re-credentialing to ensure providers stay compliant with industry standards. This helps practices maintain their accreditation over time.
Insurance and Payer Enrollment
We guide healthcare providers through the enrollment process with insurance companies and government programs like Medicare and Medicaid. Our experts manage the paperwork, ensuring timely approvals for reimbursement eligibility.
The credentialing process typically takes 1-4 months, but incomplete or incorrect submissions can delay approvals significantly, sometimes extending to a year. Following credentialing, the contracting phase begins, requiring an additional 15-45 days to complete. Each specialty has unique requirements, adding to the complexity of this process.
At CareCents, we handle the entire credentialing journey, ensuring a smooth and efficient experience. Let us take the hassle out of credentialing so you can focus on delivering excellent patient care.
Why Choose CareCents for Credentialing?
At CareCents, we specialize in delivering exceptional credentialing services tailored to meet the needs of healthcare providers. With years of experience in navigating the healthcare insurance landscape, we ensure your practice is enrolled with the leading insurance providers in the United States.
Here’s what sets us apart:
- Free Consultations: We provide personalized consultations to guide you through the credentialing process.
- NPI Registration Assistance: Enjoy hassle-free NPI registration at no extra cost.
- CAQH Profile Setup & Updates: Our team handles your CAQH registrations and keeps them updated regularly.
- Fast Initial Submissions: We initiate your credentialing applications within 24 hours of signup to expedite the process.
- Error-Free Applications: Our 99.9% clean submission rate ensures a smooth credentialing experience.
- Timely Communication: We promptly address insurance queries to minimize delays and rejections.
- Monthly CAQH Attestations: Stay ahead with regular attestations to avoid application bottlenecks.
- Contract Negotiations: We advocate for better reimbursement rates during the contracting phase.
- Consistent Follow-Ups: Our proactive follow-ups ensure timely application processing.
- Real-Time Reporting: Access up-to-date reports to track the status of your credentialing applications.
With CareCents as your credentialing partner, you can rest assured that every detail is handled with precision, enabling your practice to focus on providing exceptional patient care.
Our Comprehensive Credentialing Services
- Initial Credentialing & Enrollments
- Re-Credentialing
- Contracting & Negotiations
- Licensing & Renewals
- Malpractice Insurance Enrollments
- DEA Registrations
- Demographic Updates
- Hospital Privileges
- IPA Enrollments
Specialties We Handle
CareCents offers comprehensive credentialing services for healthcare providers across a wide range of specialties. Our team ensures full compliance with guidelines set by state regulations, private and government payers, and healthcare facilities. We tailor our approach to meet the unique needs of each specialty, ensuring seamless enrollment and credentialing.
EDI/ERA/EFT Setup
CareCents simplifies the process of establishing EDI/ERA/EFT setups with insurance companies, ensuring efficient electronic claims submission, rejection management, eligibility verification, payment tracking, denial resolutions, and electronic fund transfers. Our team streamlines these processes to optimize your billing workflow.
Re-validation
Credentialing is an ongoing responsibility, not a one-time task. Most insurance providers require timely re-credentialing or re-validation to maintain active status. CareCents ensures you never miss critical deadlines that could lead to payment delays or contract termination. We proactively track and file re-credentialing or re-validation applications, keeping your practice compliant and operational.
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Testimonials
Proven Success in Medical Billing
Family Physician
CareCents has transformed our billing process! Their team is incredibly efficient and detail-oriented. We have seen a noticeable improvement in our revenue cycle and fewer claim denials. With CareCents handling our billing, we can focus more on providing exceptional care to our patients.
