Medical Credentialing Services
Streamline Your Medical Credentialing Process with Medcare MSO
Welcome to Medcare MSO, your trusted partner for optimizing the medical credentialing process. We specialize in simplifying provider enrollment and credentialing to help expand your network. From verifying qualifications to navigating complex insurance networks, our dedicated team streamlines credentialing, allowing you to prioritize patient care and practice excellence.
Why Should You Outsource Medical Credentialing Services?
Outsourcing medical credentialing provides healthcare practices with a strategic advantage in navigating the complexities of the credentialing process. Managing provider enrollment, maintaining records, and ensuring regulatory compliance all demand specialized expertise. By outsourcing, practices can reduce the burden on internal resources, mitigate the risk of errors, and maintain a streamlined credentialing workflow.
Medical Credentialing Process
Initiate Credentialing Process:
Contact the credentialing service provider, if working
with one.
NPI Registration:
Register for a National Provider Identifier (NPI) for proper identification in billing and claims.
Medicare and Medicaid Enrollment:
Enroll with Medicare and Medicaid for government program access.
Contract Negotiation:
Negotiation is required with each insurance payer to obtain the most favorable terms and maximum reimbursement rates.
Submission to Payers:
Submit credentialing documents to the respective insurance payers.
Document Collection:
Gather all necessary documents required for
credentialing.
CAQH Registration:
Obtain CAQH registration and keep profiles updated to meet health plan requirements.
Commercial Insurance Credentialing:
Navigate the credentialing process as specified by each commercial insurance provider.
Final Document Review:
Conduct a final review of all documents to
ensure completeness.
Revalidation & Compliance Verification:
Revalidation and re-credentialing are required over time to ensure continuous compliance and active status with payers.
Medical Credentialing Process
Initiate Credentialing Process:
Contact the credentialing service provider, if working with one.
Document Collection:
Gather all necessary documents required for credentialing.
NPI Registration:
Register for a National Provider Identifier (NPI) for proper identification in billing and claims.
CAQH Registration:
Obtain CAQH registration and keep profiles updated to meet health plan requirements.
Medicare and Medicaid Enrollment:
Enroll with Medicare and Medicaid for government program access.
Commercial Insurance Credentialing:
Navigate the credentialing process as specified by each commercial insurance provider, to obtain network access and reimbursement agreements.
Contract Negotiation:
Negotiation is required with each insurance payer to obtain the most favorable terms and maximum reimbursement rates.
Final Document Review:
Conduct a final review of all documents to ensure completeness.
Submission to Payers:
Submit credentialing documents to the respective insurance payers.
Revalidation & Compliance Verification:
Revalidation and re-credentialing are required over time to ensure continuous compliance and active status with payers.
Why Choose Medcare MSO for Your Credentialing?
Maximize Your Revenue Potential
Our healthcare credentialing services optimize reimbursement processes, ensuring you get paid faster and maximize your practice’s revenue potential.
Rapid Turnaround Time
Expect a streamlined physician credentialing process with significantly reduced lag time. Our services are geared towards getting you up and running without unnecessary delays.
Highly Successful Claim Submissions
Medcare MSO has a stellar track record of successful claim submissions with over 90% first-time successful claim submission rates. Our expert team ensures that your claims are accurately processed, increasing the probability of timely reimbursement.
Tailored Solutions for Your Practice
No two practices are just alike, and neither are their needs. Medcare MSO crafts personalized physician credentialing solutions, aligning our services with your practice’s unique requirements.
What Do Customers Love About Us?
Our experience with Medcare MSO is great. They help us to increase our revenue with their quality billing and customer support services. Always recommend them to others.
Our revenue has gone up by 30%, first-through pass rates are great, and we have complete visibility through the entire process.
Medcare MSO has been and continues to be critical to the success of Ion Diagnostics. Our needs are rooted in compliance and dedicated, responsive client service. They deliver on both ends and are outstanding in revenue cycle management. Medcare MSO is a true partner.
Our Medical Credentialing Services Benefit All Kinds of Practitioners
Hospitals
Clinical Social Workers
Registered Nurses
Podiatrists
Clinics
Physical Therapists
Optometrists
Clinical Psychologists
Physicians
Occupational Therapists
Marriage and Family Therapists
Dentists
Speech-Language Pathologists
Chiropractors
Ready to experience a streamlined and efficient medical credentialing process? Partner with Medcare MSO and let our expert team provide you with smooth and efficient physician credentialing services. Maximize your revenue potential, reduce lag time, and ensure successful claim submissions.
