Provider Enrolment and Credentialing Services
Each health plan demands you to go through a contracting and credentialing process so you can treat permitted patients within their networks and obtain in-network compensation. The formal title of this procedure is “Provider Enrollment”. The way it works varies depending on the carrier, with some starting it with a phone call, some requiring the completion of standard forms, and some requiring the completion of online credentialing applications. Through CAQH, the process has been somewhat standardized, but manual intervention and regular follow-up are still necessary to guarantee that it is completed correctly and on schedule.
What does healthcare provider credentialing consist of?
Verifying a healthcare professional’s credentials, experience, and skills through provider credentialing is a systematic process. This procedure ensures that a provider complies with the requirements and rules needed to offer healthcare services in a certain location.
What is provider enrollment?
The process through which a healthcare provider becomes associated with a particular insurance network or government payer, such as Medicare or Medicaid, is known as provider enrollment. It is a specific feature of the healthcare system. Through this process, the provider is able to become part of the network and get payment for the services provided to patients who are accepted by the specific insurance plan or government program.
With a variety of Medicare Enrollment forms available, MedAR Resolve can help you in choosing the right one or forms, completing the enrollment procedure, and starting to accept Medicare patients in your office. Whether you run a single-provider or multi-provider practice, we can assist with group enrollment data, DME enrollment, registering new providers, and verifying existing providers as needed.