Medical credentialing is essential because it verifies the qualifications, experience, and professional standing of healthcare providers. This process ensures that practitioners meet industry standards and are capable of delivering high-quality patient care. Credentialing protects patients by maintaining a high level of care and safety, while also helping healthcare organizations avoid legal issues and ensure compliance with regulations. Additionally, it facilitates smooth interactions with insurance companies, enabling providers to be reimbursed for their services.

Common challenges include managing complex and time-consuming verification processes, maintaining up-to-date records, and ensuring compliance with regulatory standards.

Yes. When you sign up for credentialing with us, you get to choose exactly which panels you want, and don’t want, to be credentialed with. Typically most outpatient physician providers credential with 7-8 payors, where as hospital based physicians (in-patient) usually credential with 10-15 payors (pretty much any patient with any insurance that comes to hospital). Physicians working in tristate area (border of 3 states) like in our physician owner practice credential with 25 payors.

Professional credentialing services help maintain provider networks by ensuring that all providers meet required standards, facilitating enrollments, and managing ongoing compliance to avoid disruptions in care delivery.Most behavioural health providers, Therapists (PT, OT, ST, ABA etc) typically select 6-7 panels.

The amount of time that it takes to complete the credentialing process varies by license type. For a standard outpatient practice, the Credentialing Team will put in between 10 and 12 hours of work for each insurance panel. If an appeal has to be filed, that will add a minimum of 5 additional hours of work to that panel. Facility-based services, Home Health Care Agencies, and DMEs will all take over 20 hours to complete the credentialing process.

You bet! We have credentialed literally thousands of providers across the United States, including providers as far off as Alaska and Hawaii. No matter where your practice is, we have the experience needed to get you credentialed.

We have credentialed healthcare providers of more types than we can list: from chiropractors to behavioral health providers to surgeons. If you are eligible to be credentialed, we can get you credentialed! If you are providing a service that is new and innovative, we also offer research with the insurance companies to see if your specialty is eligible for credentialing. This can save you hours of headaches reaching out to the individual insurance panels.