Medical Credentialing Services

Leverage In-Network Provider Credentialing Services to Boost Revenue.
To effectively bill insurance companies as in-network providers, healthcare professionals—including physicians, hospitals, laboratories, emergency rooms, and urgent care centers—must successfully complete the detailed credentialing process. This complex procedure is managed through specialized medical credentialing services, which streamline the certification process and facilitate access to a broader patient base, ultimately leading to increased revenue.
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    Our Medical Credentialing Services

    Medi Bill Health Partners credentialing services
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    (347) 502-6465

    Who Requires Credentialing Services

    Payers may deny payment to unlicensed or unregistered doctors, which can significantly impact a clinic’s financial performance. MediBill Health Partners can assist with physician credentialing services in Brooklyn, NY if you are:

    A Comprehensive Overview of Our Expert-Approved Provider Credentialing Process

    Provider Assessment

    Our credentialing process begins with an in-depth survey conducted by our credentialing specialists. This process involves comprehensive interviews with providers, gathering essential data such as license numbers, educational history, demographics, and professional background.  

    Selecting the Right Insurance Partner

    Our medical credentialing services guide providers in strategically choosing insurance partners aligned with their practice goals and license type, while also finalizing insurance panels based on practice location.

    CAQH Enrollment and Management

    Our services streamline the CAQH enrollment process, handling submissions and ongoing management of ProView accounts. We ensure credentials are kept up to date for seamless primary source verification, enabling efficient payer credentialing and enhancing network participation.

    Ensure Rapid Credentialing Approval

    While the standard credentialing timeline ranges from 60 to 120 days, our provider credentialing specialists actively work to expedite the process. By maintaining weekly communication with payers, we advocate for the swift review and approval of your applications, ensuring you can begin delivering care as soon as possible.

    In-Network Enrollment

    Once credentialing is finalized, your application moves into the contracting phase. During this stage, we negotiate in-network contracts that include fee schedules and applicable CPT codes. Our team is equipped to address closed panel issues, advocating for your inclusion through effective appeals. With successful credentialing, you can bill directly, often benefiting from enhanced reimbursement rates available to in-network providers.

    From Credentialing to Care

    As the credentialing process concludes, we continue to provide support by helping you secure all required hospital privileges, including admitting, courtesy, and surgical rights.

    Ensuring Continuous Credentialing Compliance

    Our ongoing monitoring guarantees that your credentials stay up-to-date, preventing any lapses in your credentialing status. Our dedicated team carefully tracks expiration dates and conducts thorough daily and weekly reviews to ensure your credentials remain active. With our expertise, you can have peace of mind knowing that your credentialing is managed effectively.

    We manage all your accreditation and registration requirements. From completing and processing applications to submitting them to insurance providers, we diligently follow up on each application to ensure timely in-network status for our clients.
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    MediBill Health Partners
    Medi Bill Health Partners credentialing services 1

    Benefits of Choosing Our Credentialing and Enrollment Services in New York

    Complete Provider Credentialing Solutions

    MediBill Health Partners provides comprehensive provider credentialing services for healthcare professionals and organizations. Here’s an overview of the medical credentialing and enrollment services we offer:
    Empowering Providers Through Expert Contract Negotiation

    Our credentialing team assists physicians in negotiating contracts with insurance payers, establishing the terms of their relationships. Through effective contract negotiations, healthcare providers can obtain advantageous payment rates, clear dispute resolution procedures, quality benchmarks, and ensure inclusion in networks.

    Credentialing with Commercial Insurance Providers

    We credential providers with commercial insurance payers like Aetna and Humana, which are private health insurers that offer different plans and networks for their members. By credentialing with these companies, providers can access more patients and negotiate better reimbursement rates.

    Enhancing Provider Visibility with CAQH ProView Registration

    We empower providers to excel beyond their competitors. Our credentialing specialists handle the registration and upkeep of each provider’s profile on the Council for Affordable Quality Healthcare (CAQH) ProView, an online platform that gathers and verifies provider information for credentialing. Utilizing CAQH ProView enables providers to streamline their credentialing process across various health plans.

    Securing and Renewing Hospital Privileges

    We assist physicians in obtaining and renewing their hospital privileges, which grant them the rights and responsibilities to practice within a hospital’s facilities. With these privileges, providers can admit and treat patients, utilize hospital resources, and collaborate effectively with other healthcare professionals.

    Medicare and Medicaid Enrollment

    We facilitate the enrollment of providers in Medicare and Medicaid, the largest health insurance programs in the U.S., covering millions of Americans. By joining these programs, providers can broaden their patient base, boost revenue, and meet federal and state regulatory requirements.

    Expand Your Offerings with Medicare DMEPOS Enrollment

    Providers utilizing our credentialing services can enroll in the Medicare DMEPOS program, which includes coverage for items like wheelchairs, oxygen equipment, braces, and diabetic supplies. This enrollment enables providers to offer these essential items to Medicare beneficiaries, enhance their quality of care, and secure reimbursements from Medicare.

    Re-Affirmation and Re-Credentialing

    Our medical insurance credentialing service oversees the entire revalidation and re-credentialing process for physicians with Medicare, Medicaid, and commercial insurers. With MediBill Health Partners handling these tasks seamlessly, providers can ensure their continued eligibility and avoid any potential interruptions or penalties.

    Remunerate Audits

    Our team of credentialing and privileging specialists conducts audits on reimbursement matters, including underpayments, denials, delays, and payer errors. We also offer accounts receivable (AR) follow-up services to assist providers in recovering outstanding payments from insurers. By addressing these reimbursement challenges and managing AR, providers can enhance their cash flow, decrease bad debt, and streamline their revenue cycle.

     
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    Our Credentialing Services Benefit All Kinds of Practitioners

    Your Go-To Patner For Credentialing And Enrollment

    Looking for a streamlined credentialing solution? Choose MediBill Health Partners to simplify your physician credentialing process. Our dedicated team ensures swift approvals, accurate claim submissions, and the potential to increase your revenue by up to 35%.

    Let MBHP medical credentialing services experts help you get through the complicated web of payer and insurer requirements today.

    (347) 502-6465

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