credential awarded to doctor

Medical Credentialing Services

At Billing Advantage, our specialists take the guesswork and stress out of completing the credentialing process. By outsourcing to us, you’re guaranteed to have quality, up-to-date verification with just a few simple steps. Whether you’re a medical practice, a hospital, a surgery center, or a solo practitioner, we customize our credentialing and provider enrollment services to your specific needs.

Medical Credentialing Specialist

Our team of medical credentialing experts is knowledgeable and well-briefed in all criteria established by the National Committee for Quality Assurance (NCQA) and The Joint Commission (TJC). We’ll make sure your staff gets the proper credentials needed to become in-network providers with your desired insurance carriers. 

The Credentialing Process in Medical Billing

Provider credentialing involves checking a healthcare professional’s medical qualifications to prove their eligibility in administering patient care. It’s best to initiate when a new hire is onboarded and multiple times throughout their career. To become an in-network provider, many healthcare providers, including Medicare and Medicaid, request credential verification. You’ll first need to determine which insurance, HMOs, and PPOs are the most widely used plans in your area.

For a flat rate of $300 per provider, we can help you:

  • Determine if you are qualified to apply for in-network status with numerous health insurance companies, HMOs and PPOs.
  • Access the paperwork needed to apply.
  • Fill-out online applications, such as CAQH, and apply to obtain an NPI.
  • Follow-up and track your application status while supplying missing information as needed.
  • Complete any re-credentialing paperwork as requested by insurance plans. 

Medical Credentialing Solutions

Medical Credentialing is the most effective way to ensure your provider information is accurate and up-to-date. Plus, it guarantees your affiliation with insurance plans, which in turn provides you with third-party reimbursement for your patient care.

It’s often the case that insurance, HMO, or PPO panels are closed, or do not accept a particular applicant. We cannot guarantee your acceptance into any specific panel, and you may end up paying Billing Advantage to apply to panels and still not be accepted into them.

To get started, we will request that you compile some documents and information. Then, you can leave the time-consuming tasks up to us. It’s important to note that medical credentialing is a lengthy process. Depending on the insurance carrier, the enrollment process can take up to six months to complete. 

If you’re ready to move forward with medical credentialing, get in touch with our specialists today.

Other Practices

medical billing customer service

Outstanding Customer Support

Regular customer support is included for all of the services we provide at no extra cost.

read more
employee managing medical practice

Practice Management Consultation

We are medical claims and billing specialists offering a wide range of consultation services.

read more

Get Reimbursed by Insurance Companies

Contact us today to ensure your office is getting paid for the work that you do.

Get Started