Medical Credentialing Services

Get Credentialed & Enrolled.
2X Faster and Easier!

Get rid of your credentialing woes and get enrolled with great efficiency. Our
highly experienced team manages everything and processes applications with
correct information.

Book a free assesment

Medical Credentialing Services

Get Credentialed & Enrolled.
2X Faster and Easier!

Get rid of your credentialing woes and get enrolled with great efficiency. Our
highly experienced team manages everything and processes applications with
correct information.

Book a free assesment

Experience The Difference With Our Reliable Provider Credentialing Services

Experience The Difference With Our Reliable Provider Credentialing Services

We provide credentialing services to Physicians, Hospitals, Home Healthcare, laboratories, and DME credentialing services, assisting the providers in getting better revenues. Our customized credentialing services facilitate the payer enrollment process when Physicians begin their first practice after Med school, change from one practice to another, add a new Physician to an existing group, or want to become enrolled with a new payer.

Let our skilled professionals care for your documentation needs, guaranteeing precise and reliable credentialing services. Eliminate the burden of paperwork and simplify the application process. Enhance your revenue cycle management and reduce claim denials with our efficient services. Gain a competitive advantage by choosing our cost-effective solutions, giving you an edge over others in the industry.

We provide credentialing services to Physicians, Hospitals, Home Healthcare, laboratories, and DME credentialing services, assisting the providers in getting better revenues. Our customized credentialing services facilitate the payer enrollment process when Physicians begin their first practice after Med school, change from one practice to another, add a new Physician to an existing group, or want to become enrolled with a new payer.

Let our skilled professionals care for your documentation needs, guaranteeing precise and reliable credentialing services. Eliminate the burden of paperwork and simplify the application process. Enhance your revenue cycle management and reduce claim denials with our efficient services. Gain a competitive advantage by choosing our cost-effective solutions, giving you an edge over others in the industry.

Why is Medical Credentialing Important?

Medical credentialing is important because the process offers patients a chance to confidently trust their selected physicians. It
means providers are vetted for their education, degrees, work history, behavior, and other legalities before they become part of a
payer network. Similarly, before a provider joins an organization, hospital, or surgery center, their documents and degrees are
verified by a credentialing entity. Often discussed along with medical credentialing is the process of enrollment. It is the process of
applying to the insurance network to be included in their panel of providers.

Why is Medical Credentialing Important?

Medical credentialing is important because the process offers patients a chance to confidently trust their selected physicians. It
means providers are vetted for their education, degrees, work history, behavior, and other legalities before they become part of a
payer network. Similarly, before a provider joins an organization, hospital, or surgery center, their documents and degrees are
verified by a credentialing entity. Often discussed along with medical credentialing is the process of enrollment. It is the process of
applying to the insurance network to be included in their panel of providers.

A Walkthrough of Our Specialist-Vetted Provider Credentialing Process

A Walkthrough of Our Specialist-Vetted Provider Credentialing Process

Surveying the provider

Our credentialing process begins with an in-depth survey conducted by our credentialing specialists. This process involves comprehensive interviews with providers, gathering essential data such as license numbers, educational history, demographics, and professional background.

Choosing the insurance company

Our medical credentialing services guide providers in strategically choosing insurance partners aligned with their practice goals and license type, while also finalizing insurance panels based on practice location.

CAQH Enrollment and Management

We take care of CAQH application submissions, manage ProView accounts, and keep credentials current for smooth primary source verification. We also assist with payer credentialing submissions, ensuring quick insurance panel integration and accurate profiles that enhance network engagement and the quality of patient care.

Surveying the provider

Our credentialing process begins with an in-depth survey conducted by our credentialing specialists. This process involves comprehensive interviews with providers, gathering essential data such as license numbers, educational history, demographics, and professional background.

Choosing the insurance company

Our medical credentialing services guide providers in strategically choosing insurance partners aligned with their practice goals and license type, while also finalizing insurance panels based on practice location.

CAQH Enrollment and Management

We take care of CAQH application submissions, manage ProView accounts, and keep credentials current for smooth primary source verification. We also assist with payer credentialing submissions, ensuring quick insurance panel integration and accurate profiles that enhance network engagement and the quality of patient care.

Ensure Fast Credentialing Approval

Although the typical timeline is 60-120 days, our provider credentialing experts take proactive steps to accelerate the process. Our team engages in weekly interactions with payers, advocating for the rapid processing and endorsement of your credentialing applications.

In-Network Enrollment

Upon completing credentialing, your application enters the contract phase. Here, an in-network contract may be offered, including fee schedules and eligible CPT billing codes. We handle closed panel challenges, advocating through appeals to secure your inclusion. With successful credentialing, direct billing becomes feasible, often with preferred reimbursement rates for in-network providers.

Winning you Hospital Privileges Application

As credentialing wraps up, our active involvement persists. We assist you in gaining all necessary hospital privileges: whether it’s admitting, courtesy, or surgical rights.

Ensure Fast Credentialing Approval

Although the typical timeline is 60-120 days, our provider credentialing experts take proactive steps to accelerate the process. Our team engages in weekly interactions with payers, advocating for the rapid processing and endorsement of your credentialing applications.

In-Network Enrollment

Upon completing credentialing, your application enters the contract phase. Here, an in-network contract may be offered, including fee schedules and eligible CPT billing codes. We handle closed panel challenges, advocating through appeals to secure your inclusion. With successful credentialing, direct billing becomes feasible, often with preferred reimbursement rates for in-network providers.

Winning you Hospital Privileges Application

As credentialing wraps up, our active involvement persists. We assist you in gaining all necessary hospital privileges: whether it’s admitting, courtesy, or surgical rights.

MCR DMEPOS Enrollment

Providers using our credentialing service can enroll in the Medicare DMEPOS program, which covers items such as wheelchairs, oxygen equipment, braces, and diabetic supplies. By enrolling in this program, providers can offer these items to Medicare beneficiaries, improve their quality of care, and receive reimbursement from Medicare.

Ongoing Monitoring and Updates

Our continuous oversight ensures that your company’s credentials remain current and that you stay credentialed without interruption. Our experts diligently track your credentialing expirations and conduct comprehensive daily and weekly reviews to maintain your active status. You can rest easy knowing that your credentials are in good hands with us.

Credentialing

Revalidation & Re-Credentialing

Our medical insurance credentialing service manages every physician’s revalidating and re-credentialing enrollment process and credentialing status with Medicare, Medicaid, and commercial insurers. With Health First RCM managing these processes on autopilot, providers can maintain their eligibility to participate in these programs and avoid any interruptions or penalties. care professionals.

MCR DMEPOS Enrollment

Providers using our credentialing service can enroll in the Medicare DMEPOS program, which covers items such as wheelchairs, oxygen equipment, braces, and diabetic supplies. By enrolling in this program, providers can offer these items to Medicare beneficiaries, improve their quality of care, and receive reimbursement from Medicare.

Ongoing Monitoring and Updates

Our continuous oversight ensures that your company’s credentials remain current and that you stay credentialed without interruption. Our experts diligently track your credentialing expirations and conduct comprehensive daily and weekly reviews to maintain your active status. You can rest easy knowing that your credentials are in good hands with us.

Revalidation & Re-Credentialing

Our medical insurance credentialing service manages every physician’s revalidating and re-credentialing enrollment process and credentialing status with Medicare, Medicaid, and commercial insurers. With Health First RCM managing these processes on autopilot, providers can maintain their eligibility to participate in these programs and avoid any interruptions or penalties. care professionals.

Health First RCM Offers The Best Credentialing Services Near You In The USA

Looking for the best credentialing solutions by credentialing specialist companies near you? With over a decade of experience, Health First RCM is the best provider credentialing company for practices across all 50 states of the USA. 

We start by thoroughly assessing your specific practice needs and the requirements of your state and the payers you want to work with. From there, we leverage our extensive payer contracts and relationships to compile and verify all necessary documents, licenses, certifications, insurance, and more to meet each payer’s distinct criteria.

For example, when credentialing a physician in California, we would verify their medical license with the Medical Board of California, check for any disciplinary actions on the National Practitioner Data Bank, review their malpractice insurance coverage, and collect a current CV and diploma before submitting to health plans like Blue Shield of California and Health Net.

Additional credentialing services like re-credentialing, expediting credentialing, and credentialing for locum tenens providers are also a part of Health First RCM Provider Credentialing and Enrollment Service offerings.

Health First RCM Offers The Best Credentialing Services Near You In The USA

Looking for the best credentialing solutions by credentialing specialist companies near you? With over a decade of experience, Health First RCM is the best provider credentialing company for practices across all 50 states of the USA. 

We start by thoroughly assessing your specific practice needs and the requirements of your state and the payers you want to work with. From there, we leverage our extensive payer contracts and relationships to compile and verify all necessary documents, licenses, certifications, insurance, and more to meet each payer’s distinct criteria.

For example, when credentialing a physician in California, we would verify their medical license with the Medical Board of California, check for any disciplinary actions on the National Practitioner Data Bank, review their malpractice insurance coverage, and collect a current CV and diploma before submitting to health plans like Blue Shield of California and Health Net.

Additional credentialing services like re-credentialing, expediting credentialing, and credentialing for locum tenens providers are also a part of Health First RCM Provider Credentialing and Enrollment Service offerings.

READY TO START?

Start Today & Get Enrolled Faster!

Book a free assesment

READY TO START?

Start Today & Get Enrolled Faster!

Book a free assesment

What Our Client Saying

John Doe
    John Doe

    CEO

    "I began working with Health First RCM 2 years ago. They are incredibly knowledgeable and very professional. Their billing and coding teams are highly skilled and have the experience to handle any specialty. My collections doubled when they took over the billing and coding tasks. Their cooperation and expertise are greatly appreciated."

    John Doe
      John Doe

      CEO

      "I began working with Health First RCM 2 years ago. They are incredibly knowledgeable and very professional. Their billing and coding teams are highly skilled and have the experience to handle any specialty. My collections doubled when they took over the billing and coding tasks. Their cooperation and expertise are greatly appreciated."

      John Doe
        John Doe

        CEO

        "I began working with Health First RCM 2 years ago. They are incredibly knowledgeable and very professional. Their billing and coding teams are highly skilled and have the experience to handle any specialty. My collections doubled when they took over the billing and coding tasks. Their cooperation and expertise are greatly appreciated."

        What Our Client Saying

        John Doe
          John Doe

          CEO

          "I began working with Health First RCM 2 years ago. They are incredibly knowledgeable and very professional. Their billing and coding teams are highly skilled and have the experience to handle any specialty. My collections doubled when they took over the billing and coding tasks. Their cooperation and expertise are greatly appreciated."

          John Doe
            John Doe

            CEO

            "I began working with Health First RCM 2 years ago. They are incredibly knowledgeable and very professional. Their billing and coding teams are highly skilled and have the experience to handle any specialty. My collections doubled when they took over the billing and coding tasks. Their cooperation and expertise are greatly appreciated."

            John Doe
              John Doe

              CEO

              "I began working with Health First RCM 2 years ago. They are incredibly knowledgeable and very professional. Their billing and coding teams are highly skilled and have the experience to handle any specialty. My collections doubled when they took over the billing and coding tasks. Their cooperation and expertise are greatly appreciated."

              Relieve the stress from RCM & Billing complexity and improve your practice with Health First RCM

              Get started today with a no-risk, no-obligation trial.

              Book a Free Trial

              Relieve the stress from RCM & Billing complexity and improve your practice with Health First RCM

              Get started today with a no-risk, no-obligation trial.

              Book a Free Trial

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