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Credentialing

Provider Enrollment and Credentialing

Without proper credentialing, physicians can’t get paid—don’t make that mistake. Let the trusted experts at Physibill get you off to the right start! Our team handles new enrollments, CAQH updates, Medicare re-validation, re-credentialing with commercial plans, expirables management, and much more. Let us be your healthcare credentialing partner and assist you in maintaining your credentials.

New Credentialing Services:

  • Completion of credentialing applications with various health plans and follow-up until credentialed
  • Review of contracts
  • Assistance with obtaining CAQH ID
  • Assistance with obtaining NPI #

Credentialing Maintenance Services:

  • Completion of re-credentialing applications with various health plans
  • Medicare re-validation
  • CAQH re-attestations
  • Expirables management
  • Assistance with denied claims due to credentialing issues

Credentialing tasks we fulfill:

  • Determine if you are eligible to apply for in-network status with various insurance/HMOs/PPOs.
  • Obtain the necessary paperwork to complete the request.
  • Apply to get an NPI.
  • Complete online applications, plus CAQH and other credentialing administrations.
  • Accelerate Medicare enrollment through PECOS.
  • Follow up to track the status of applications and supply missing information as needed.
  • Complete re-credentialing paperwork as requested by insurances/HMOs/PPOs.

Credentialing process:

At Physibill, we will:

  • Request several pieces of information required to apply for your credentialing and CAQH application.
  • Forward forms to you for completion that need information only you can provide, such as clinical specialties.
  • Send forms to you for signing if they require your signature.
  • Inform you of what is needed; the successful completion of this process relies on your timely provision of the necessary documents and information.

Please be aware that the credentialing process can take considerable time. For many insurances, the duration from our initial inquiry to your acceptance into a panel and your ability to begin seeing patients can be as long as 6 months.

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MEDICAL BILLING SERVICES

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CREDENTIALING SERVICES

We handle the full credentialing process or collaborate with you to secure your in-network status.

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PRACTICE ANALYTICS SERVICES

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