Credentialing Services
START SEEING PATIENTS IN WEEKS NOT MONTHS
It’s easy enough to decide on your organization’s name, structure, and logo, but if you start doing provider credentialing incorrectly, you may have to wait months before you can start seeing patients, not to mention the delay in your cash flow.
Insurance credentialing plays a vital role in the healthcare industry, allowing healthcare providers to participate in insurance networks and receive reimbursement for their services. However, the credentialing process can often be complex and overwhelming, especially for healthcare providers who are new to it.
Insurance credentialing is the process by which healthcare providers apply to become affiliated with insurance companies or networks. It involves verifying the qualifications, credentials, and background of healthcare providers. We ensure that healthcare providers meet all the necessary regulatory and insurance requirements per the National Committee on Quality Assurance (NCQA) and the Centers for Medicare and Medicaid Services (CMS). We are experts in Provider credentialing whether its solo practitioners, multi-physician practices in an office or in hospital setting, MDs, DOs, NPs (nurse practitioners), counselors, chiropractic, and ancillary labs.
An incorrect or delayed credentialing can cost you, on average, tens of thousands of dollars annually. MGMA (Medical Group Management Association) surveyed 425 respondents in 2021 where 54% of the practices reported an increase in claim denials due to inaccurate provider credentialing. Increase your cash flow by letting us do your credentialing correctly and promptly.
We credential providers with CAQH, Medicare, Medicaid, commercial insurance, PPO, and HMO health plans. To start the process of provider credentialing, reach out to CMM as soon as you decide the name of your practice or add a new provider to the practice. We can guide you with the documents needed for credentialing and provide a suggested list of insurance companies for your consideration. Once we receive the required documents and pertinent information, enrollment applications are submitted within a week. We track each application and utilize our relationships developed through the credentialing of many providers, to quickly advance the credentialing and contracting process.
Typically, insurance companies require credentialing for the following providers:
- Physicians MDs, DOs
- Dentists
- Physical Therapists,
- Speech Therapists
- Psychology Counselors
- Occupational Therapists
- LMFT
- Group Medical Practices
- Clinics
- Hospitals
- DME Companies
- Home health agencies
- Nurse Practitioner
- Medical Assistant
We offer customized packages for Solo Practitioners, Small-Size Practitioners (2-5 providers), Mid-Size (6-20 providers), Large Clinics and Hospitals (more than 20 providers).