CREDENTIALING SERVICES

The credentialing process involves verifying a provider’s background and qualifications for providing health services. Payers require verification of a provider’s education, experience, training, certification, and more. This process is complex, time-consuming, and exhausting. Taking this all on yourself costs time and attention away from your practice operations and your patients. With CredentialingOne, we do all the work! Our credentialing services are done by industry experts with the knowledge and technology to alert you every step of the way.

Credentialing & Recredentialing
Providers

Let our experts remove the headache of filling out provider credentialing paperwork by cutting through all the red tape for you. Our automation technology autopopulates credentialing forms and our experienced staff ensures your submitted application gets processed. (Credentialing Process) Simply review the documentation and sign (if required) for submission.  

Facility Credentialing
Hospitals & Large Healthcare Providers

Facility credentialing can be a difficult process. To be credentialed as a facility requires numerous requirements and standards. Facilities should begin 120 days prior to when they wish to accept payments from payers.

A practice, group, or facility must have all providers’ and locations’ NPIs credentialed and contracted with payers. It is not unusual for a practice without a credentialing program to fail to add any new locations or plans to their existing agreements. These types of omissions will result in denied claims and lost revenue. 

We will prevent these issues by obtaining a Type 2 NPI for your locations and completing all required applications and demographic changes for your payers. 

We also can enroll a FQHC facility and a provider with insurance companies (Medicare, Medicaid, Tricare and Commercial plans such as UHC, Humana and Aetna) for maximum reimbursement.

We Can Help:

Medical Doctors | Nurse Practitioners | Hospitals | Large Healthcare Providers | Physician Assistants | Dentists | and More!

credentialing process

Additional Benefits

  • Primary-source verify credentials
  • Stay informed every step of the way with our alerts and reports
  • No need to hire and train additional employee(s) to manage your future credentialing and contracting
  • Utilize our services as temporary staffing for credentialing and enrollment
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PREVENT THESE CREDENTIALING MISTAKES

CredentialingOne can help you avoid these and other errors that lead to denials and underpayments:

INCORRECT PHYSICIAN DATA

An incorrect entry in the insurance plan's billing system

SUBMITTING A CLAIM INCORRECTLY

Incorrect practice or facility data when submitting a claim

EXPIRED CERTIFICATES

Expired licenses, certificates, or insurance

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