Credentialing

Our service includes provider enrollment and primary source verification. We work with all specialties and assist with enrollment in all insurance networks (Medicare, Medicaid, and Commercial Insurance). Our credentialing solution fits any organization regardless of size or specialty. If you are an individual or a medical group Physicians Resource medical credentialing service will keep you organized and up to date.

 

Smiling female doctor with colleague in background

Credentialing comes before even bill your first claim is submitted. Failing to manage the credentialing and contracting process WILL cause loss in revenue.

To most, credentialing is a long drawn out process, filled with completing applications, waiting on hold for provider relation representatives, and gathering lots of documentation. No worries! We can help!

At some point, your practice may decide to accept new insurance payers. This will require establishing contracts with the new insurance company. We can help you establish contracts and review the fee schedule for the new insurance company.

We are here to ensure that your office obtains its credentials accurately and on time. We have the experience and knowledge you need to get through the process with the least headache and amount of worry.

Our credentialing services include:

  • Provider enrollment services for physicians and healthcare entities (credentialing and contracting with health plans)

  • Medicare provider enrollment and re-validation services

  • Credentials verification for physicians and ancillary healthcare providers

  • Network management for health plans

  • Outsourced hospital privileging (outsourced medical staff office)

  • Managed care contracting

  • Healthcare administration consulting services

 

Our staff will work with any insurance companies to get your practice providers enrolled with health plans and to maintain your providers credentialing files.

Benefits:

  • Keep all your credentialing information in one place.

  • Years of experience to navigate through the process of Medicare and Medicaid provider enrollment, Commercial Insurance Provider Enrollment, and other healthcare provider credentialing needs.

  • Status reports keep you up to date on the progress of your credentialing

  • You and your medical office staff can focus on more important patient matters than dealing with enrollment paperwork

  • Joint Commission Credentialing Package (All Current Licenses, All Current DEA or CDS, Registration, NPDB , SAM, Board Certification if applicable, etc.)

  • Application completion

  • Data entry of paper applications

  • Application mailing service