Provider Credentialing

The process of credentialing is not just critical to developing a practice that strives to deliver top-notch patient care; it is also essential when it comes to insurance reimbursement. It is through the credentialing process, that insurance providers are able to determine which of the providers actually meet all requirements.

At Pro Clinical Solutions, our objective is to successfully credential as well as recredential our partners into various PPO / Managed Care organizations, including online enrollment through the CAQH (Council for Affordable Quality Healthcare).

The Credentialing Department at Pro Clinical Solutions is well-equipped to manage the entirety of credentialing process for you. Here’s an overview of what the credentialing process typically includes:

Initial verification for provider current enrolment status with the carrier

Necessary document retrieval for credentialing including documents validity tracking.

Finishing up the application for initial credentialing as well as recredentialing.

Submitting application for the health plans.

Regular follow ups with insurance carriers for application status check and update until it gets approved.

Post credentialing approval; our team ensures to update the database and Billing system for smooth claim submission and processing to get it paid at very first Submission

Separate database maintenance for the carrier lists and credentialing approvals

Obtaining NPI (National Provider Identifier) numbers.

At Pro Clinical Solutions, our Credentialing Department consists of brilliant Credentialing Coordinators and Analysts with years of wide credentialing experience that includes hospitals, PPOs, HMOs, IPAs, and managed care companies. And it’s a staff dedicated to use its diverse knowledge and experience to provide excellent full-time credentialing service to all our clients.

Pro Clinical Solutions provides best credentialing services across USA. The most affordable medical billing service that streamlines your billing practices.