How to Handle the Physician Credentialing Process with Ease

Physician Credentialing – A Necessity

A couple of decades ago healthcare professionals considered physician credentialing as the procedure for enrolment with an insurance company’s preferred provider network.  Nowadays, it is more mandatory than ever for physicians and healthcare providers including nurses, chiropractors, psychologists, counselors, LCSW and many others to be in network with insurance companies. This is a necessity because most people in the United States have health insurance than ever before.  And it is necessary because people today demand their healthcare physicians accept their insurance.  Honestly saying, if a physician is not in network with a patient’s health insurance plan, the provider is at risk of losing that potential patient to a competing practice.

The Physician Credentialing Process

Medical Credentialing referred to as insurance credentialing or provider enrollment is the process of becoming affiliated with an insurance company so that physicians can accept third-party reimbursement. Here, enrollment applications can be +40 pages long, and to ensure smooth processing there is a lot of necessary, time-consuming, follow-up.

The process of getting on insurance panels can be challenging and lengthy.  As a matter of fact, it takes between 2-3 months to submit the necessary paperwork and correspond with insurance companies’ credentialing departments, before getting approved to join an insurance panel.  Because of the large amount of paperwork and correspondence required, medical providers generally find the process to be very time-consuming.

Credentialing Management

Medicare, State Medicaid, and Private/Commercial Payer Management involves

• New Payer Contracts or Enrollments

• Re-Credentialing or Revalidations

• Changes of Information- Ownership or Acquired Locations

• NPI Enumeration / Management

• Set up EDI, EFT, ERA, and PECOS Processes or Provider Web Portals

• Payer Issue Liaison / Resolution with Payers

• Local, State, and Federal Licensure Procurement

How Bristol Healthcare can assist you

Why not choose a professional credentialing service provider like Bristol Healthcare Services to complete your provider enrollment process?

Bristol Healthcare Services is a medical billing and coding company serving physicians for over 20 years. We offer the entire gamut of billing and coding services. Physician credentialing and enrollment is a service we offer to make the whole credentialing process a smooth one for physicians. Our team ensures that all documentation needed for this process is complete. Be assured that we will eliminate the stress involved in this process.

Reach out to us today. We are here to help you!