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Credentialing

We provide credentialing services for an hourly rate. The first step in this process is for you to determine which insurance/HMOs/PPOs are the most widely used insurance companies in your area. We then work with you to apply for in-network status. Some of our customers prefer to share these responsibilities, and have us do some of the work and do some of the work themselves. The tasks we can help with include the following:

  • Determine if you are eligible to apply for in-network status with various insurance/HMOs/PPOs.
  • Obtain the necessary paperwork to apply.
  • Complete on-line applications,including CAQH and other credentialing organizations.
  • Apply to obtain an NPI.
  • Follow up to track the status of applications and supply missing information as needed.
  • Complete re-credentialing paperwork as requested by insurances/HMOs/PPOs

A few things to keep in mind when using this service.

  • There are likely to be forms that need information that only you can fill out, such as clinical specialties, etc. We will forward these forms to you for completion.
  • Many forms will require your signature. We will send you these forms to be signed. Please be sure to mail us the signed original.
  • It is often the case that insurance/HMO/PPO panels are closed, or do not accept a particular applicant. We cannot guarantee that you will be accepted into any particular panel, and you may end up paying Billing Advantage to apply to panels for you and still not be accepted into these panels.
  • We will need several documents and pieces of information from you to complete this process. We will let you know what is needed, and the successful completion of this process relies on your supplying the needed documents and information to us in a timely fashion.
  • The credentialing process can take a very long time. Please expect that for many insurances, the time from when we first inquire to when you are actually accepted into a panel and can begin seeing patients can be as long as 6 months.

Our hourly rate for credentialing services is subject to change, and is currently $75.00 per hour.

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