provider credentialing services
Fast and accurate Provider Credentialing services

Provider Enrollment and Credentialing Services in healthcare is as fundamental as a physician's license to practice. This essential process, known by various names—medical credentialing, healthcare credentialing, or insurance credentialing—is mandated by authoritative bodies like CMS and the Joint Commission. Insurers require credentialing to add physicians as in-network providers, a status that's essential for eligibility to receive reimbursements.

For a provider, credentialing is an exhaustive process involving every health plan they intend to enroll in, and it can feel like an avalanche of paperwork. Normally, this process might take anywhere from 30 days to 6 months. However, MedQuik Solutions drastically reduces this provider enrollment time frame to between 8-14 days, thanks to our advanced technology and automated software.

Extended credentialing periods can impose a financial strain on practices. We expedite this process, minimizing any potential financial impact. Our technology is designed to prevent delays that can arise from even minor errors, ensuring error-free and swift provider enrollment and credentialing services. Staying abreast of regulations and with persistent follow-ups, MedQuik ensures broad and expedient access to care.

When Credentialing Is Essential
  • New Graduates : Doctors, nurses, and therapists starting their careers.

  • Healthcare Transitions : Any provider moving to a new state or facility.

  • Private Practice : Dentists and other specialists setting up on their own.

  • Insurance Updates : Providers joining new health plans for broader patient access.

  • Regular Updates : Ongoing re-credentialing is required for all practitioners.

provider enrollment and credentialing services
Benefits of Choosing Our Service

Choosing our medical billing and credentialing services ensures unparalleled support and efficiency for healthcare providers. Our dedicated specialists bring expertise in handling a wide range of provider types, ensuring a smooth credentialing journey. We offer customized support that adapts to the unique needs of each provider, from solo practitioners to large medical groups. Our process is designed to minimize delays in provider enrollment, allowing for a quicker start to billing and service delivery. By leveraging our comprehensive support, healthcare providers can navigate the credentialing landscape with ease, ensuring they meet all compliance requirements while focusing on delivering quality care to their patients.

Our Credentialing Service
  • Aligning provider qualifications with industry standards from NCQA, URAC, and AAAHC.

  • Leveraging the latest digital tools for effective background information compilation.

  • In-depth verification to ensure provider credentials are current and robust.

  • Facilitates provider in-network status with insurance for seamless reimbursement.

  • Ongoing re-credentialing for sustained compliance with provider network requirements.

  • Proactive renewal management for licenses and certifications to avoid any service gaps.

  • Comprehensive navigation of Medicare, Medicaid, CAQH, and non-CAQH payer complexities.

  • Customized support for healthcare providers across all practice sizes and specialties.

  • Efficiency in credentialing timelines, significantly surpassing the typical industry pace.

  • Determine which insurance companies are the practice's major payers and reach out to them.

The Credentialing Process
  • We begin with a thorough consultation to understand your specific credentialing requirements, whether you’re a solo practitioner, part of a group practice, or a healthcare facility.

  • Our team assists in the collection of all necessary documents, including licenses, certifications, and professional references, leveraging our digital platform for ease and efficiency.

  • Each piece of information is meticulously verified against primary sources. This includes educational background, training, board certifications, work history, and any necessary legal checks.

  • With all documents verified, we compile and submit your credentialing application to the relevant healthcare plans and facilities, ensuring completeness and accuracy to avoid delays.

  • MedQuikSolutions acts as an active intermediary between you and the credentialing bodies, handling all follow-up communication to ensure a smooth approval process.

  • Even after approval, we continuously monitor credentialing status, including renewal dates and compliance requirements, to ensure you remain in good standing with all networks and regulatory bodies.

  • Credentialing isn’t a one-time event. We provide re-credentialing services to manage and maintain your credentials, keeping them current and compliant with evolving standards and regulations.

  • Clients receive detailed reports at each step of the process, offering insight into the status of their credential applications and any actions required.

Credentialing Essentials
Physicians :
  • Primary Source Verification (PSV) : Direct verification of qualifications from original sources.

  • ECFMG Certification : For graduates from medical schools outside the U.S

  • FCVS Portfolio : A comprehensive record of a physician's core medical credentials.

  • NPDB Check : Information on malpractice payments and professional conduct.

  • Board Certification : Verification of specialty expertise.

  • CME Credits : Confirmation of ongoing education to maintain licensure.

  • State Licensure : Essential for legal medical practice within a specific state, affirming compliance with state-specific medical standards.

  • DEA Registration : Authorizes the physician to prescribe controlled substances, ensuring adherence to federal drug policy and regulation.

Nurse Credentialing :
  • Licensure Verification : Confirmation of a current, unrestricted nursing license.

  • Education Verification : Validation of nursing education from accredited programs.

  • Certification Verification : For nurses with specialized roles or advanced practices.

  • Clinical Privileges : Specific to APRNs, detailing authorized practice scope.

  • Background Checks : Comprehensive checks for safety and reliability.

Behavioral Health Professional Credentialing :
  • Licensure Verification : Ensures valid licensure for practice in their specialty.

  • Education and Training : Verification of degrees from accredited programs.

  • Certification Verification : Validates specialized certifications, if applicable.

  • NPDB Check : Reviews for malpractice or disciplinary actions.

  • Professional References : Assesses professional conduct and clinical skills.

  • Background Checks : Ensures no criminal convictions or sanctions.

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