What does Credentialing Mean in Healthcare?
Medical Credentialing is a detailed process by which “a healthcare organization analyzes and verifies the qualifications of a medical provider”. Additionally, the providers must have gone through strict scrutinization by Insurance companies regarding their ability to practice the medicine in the healthcare marketplace.
In Credentialing, the Insurance company conducts an intensive verification procedure that checks and verifies the physician’s background, such as their education, competencies, and legal authorization to practice medicine.
At NEO MD, our team of knowledgeable staff use their best expertise in the credentialing process, such as; staying updated with the industry changes, credentialing trends, and the payer requirements. As a dedicated team, we take full accountability for the whole credentialing process from the start till the end on your behalf.
With NEO MD at your back, you can truly rely on us for getting your Credentialing done within weeks. We will share your stress and get your enrollments faster than usual!
Why is Credentialing Important for Medical Assistants or Providers?
Medical Credentialing ensures that the Medical Assistants or Providers are trained, certified and have the required experience to give the best healthcare services to their patients. It is one of the most critical aspects of maintaining the true standards of trust, confidence, reliability and safety in the healthcare profession.
One of the major setbacks for the providers, if they lack Medical Credentialing, is that they can’t enjoy reimbursements from the Insurance companies whether they are Federal Payers or Commercial Insurances. Also, it can be really challenging for the medical assistants to work with any healthcare software solutions without Medical Credentialing.
NEO MD Credentialing Services for Providers
Where we can help? We provide Complete credentialing solutions; unlike other RCM service vendors, we are only focused on providing you with the best credentialing solutions. Our services include but are not limited to,
State License Renewal
NPPES Enumeration/NPI creation
Insurance Portal Creation
EDI/ERA, EFT Setups
Federal insurances Enrollment
We guarantee you Medicare/Medicaid approval in first go. We can get you enrolled faster using extensive knowledge of MCR/MCD application filing and accurate submission of your application. RR MCR, Tricare, BWC, TriWest any federal payer you wish to get enroll with, we’re here to help!
Looking to join an IPA (Independent Providers’ Association) and an or MSO (Management Service Organization)? We have major IPA/MSO’s of every state in our contact and we can help you get paneled faster and without any processing delays.
We understand the roles of ACO/MCO’s and we can help you choose a best one to go with, our team of dedicated professionals have worked with hundreds of ACO’s and a number of MCO’s and we’re ready to share our expertise!
Worried about your Revalidation? don’t worry, you have come to the right place. Our team of expert credentialing specialist would take care of your revalidation doesn’t matter if it’s with MCR/MCD or re-credentialing with any other commercial payer.
License expiry date approaching? Or looking to start practicing in new state? Don’t worry our team of licenses professionals know how to handle it well. We’ll apply for your new or renew your state license, DEA, Accreditation, CDS and or certification.
CMS has developed the National Plan and Provider Enumeration System (NPPES) to provide the distinctive identifiers to healthcare providers. NPPES is the database that contains all of the related information. It is used by NPI number holders and the Centers for Medicare and Medicaid Services.
Hospital affiliations or privileges for a doctor depicts that the doctor has privileges to examine, treat and manage patient as outpatient or inpatient within that hospital and the hospital has credentialed the doctor for this particular reason.
ADD ON SERVICES
Not happy with your current reimbursement rates and looking for a better contract? You have come to the right place. We have a dedicated team of Negotiators, and we can help negotiate your current contract with any commercial payer. We understand you’re working hard and try our best to make sure you get the maximum reimbursement rates.
Not happy with your current reimbursement rates and looking for a better contract? You have come to the right place. We have a dedicated team of Negotiators and we can help negotiating your current contract with any commercial payer. We understand you’re working hard and try our best to make sure you get the maximum reimbursement rates.
New Insurances/plans addition
Worried about practice patient volume? We can help you add additional plans on your existing enrollment and or help you get enrolled with additional insurances so you may never have to say NO to a patient wanting to come with a plan which you don’t already take.
Interested in joining a closed panel insurance network? no problem, we can help you file a network review request and or appeal to make the network management change their decision of not giving you the contract. Yes, you heard it right!
Not getting the payments on time? Our team of enrollment specialists can you get setup for ACH payments so you get paid faster and won’t miss any paper check.
We can help register on PECOS, Optum, Availity, Navinet or any other provider portal so you may go online for checking your claims status, verifying PT eligibility and or obtain or initiate authorization.
Worried about choosing the right insurance to work with? No problem, we are here to help. We know the healthcare market and can suggest you commercial insurances which would offer you maximum reimbursement rates and great patient volume.
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