What are Credentialing Services and why use them?

Credentialing Services

Credentialing is the process of verifying a provider’s qualifications to ensure that they can provide care to patients. Most health insurance companies require this process including CMS/Medicare, Medicaid, and Commercial plans, as well as hospitals and surgery centers.

The Credentialing process is completed by verifying all of a provider’s documents to ensure that they are valid and current. These include their medical license, malpractice insurance, and DEA.
Additional information necessary to complete credentialing:

  • Medical School information
  • Internship/Residency/Fellowship’s Information
  • Board Certifications
  • Provider’s CV

By enlisting the help of a medical credentialing services company, such as Eddy, they are able to assist you with provider enrollment and becoming an in-network provider. This will allow you to receive reimbursements from each carrier. Only a few years ago healthcare professionals viewed medical credentialing “optional” for building a practice, today it has become necessary for providers to be in network with insurance companies. Learn how Eddy can help you get the proper credentials for your medical practice. Our upfront pricing is the only available in the industry.

Why use a Credentialing Service?

Becoming a provider with commercial and government insurance companies allows you to maintain consistent patient referrals and cash flow. Credentialing Services provide contracting and physician credentialing services to practices of all sizes and in all specialties.

The credentialing process can be complicated and time consuming. Outsourcing the provider credentialing process allows providers and administrators to focus on what they do best: delivering a superior patient experience.

Additionally, application errors may lead to delays and denials. A typical credentialing application will ask for practice address, phone, fax, contact information, services provided, copies of your licensure, employment history, average patient profile and any records of past legal troubles regarding your medical practice.

Omitting or making mistakes on any of this data can lead to delays in your provider credentialing, and it can sometimes be grounds for a denial.

By outsourcing to a reputable credentialing service provider, you are ensuring accurate, fast credentialing to set you and your organization up for success.

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