CareCloudMB Medical Coding Services
Improve Speed-To-Care with Our Sophisticated Medical Credentialing Services
Medical credentialing services are a time-consuming and labor-intensive process because of plan complexities and eligibility criteria involving licenses, certifications, training records, malpractices, and adverse clinical occurrences of a healthcare provider. A simple error can delay enrollment and cause potential revenue loss, denying patient access to you. Outsource your credentialing services to CareCloud MB to accelerate reimbursement and privileges, eliminating your staff burdens.
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1st Class Reimbursement
Drive your practice to new heights of profitability and efficiency with first-preference reimbursement rates, getting paid more for the same services with our efficient medical credentialing services.
Maximum Privileges
Our credentialing specialists not only streamline your practice but also secure vital privileges. They provide you with innovative programs and incentives for quality performance.
Billing-Ready
Deploying the best technology and incredibly sophisticated approaches to prepare you to bill from day one, receiving a unique provider identification number (PIN) that allows you to electronically submit claims and track them online.
Swift Reimbursement
Faster reimbursements ensure a healthy cash flow for your practice. You won't have to wait for months to receive your payments, as we process claims within 15 to 30 days on average.
Payer Support
Our professionals are adept at negotiating reimbursement rates on your behalf with insurance companies to ensure uninterrupted cash flow for your practice.
Minimize Denials
Claim denial creates cashflow disruption which is detrimental to your practice growth. We obtain authorization, verify eligibility, reduce errors, and rejections, submitting accurate claims.
CareCloud MB Provider Credentialing Services
With Industry-Best Medical Credentialing Services, We Enroll You in Premium Payer Networks
Medical credentialing services include verifying certifications, qualifications, training records, skills, malpractices, and affiliations of a healthcare provider to ensure that he has the legitimacy and competency to provide healthcare services to patients.
Only credentialed providers are eligible to receive payments from the payer and work in line with state and federal regulations. Medical credentialing authorizes healthcare providers to practice in a specific healthcare organization and be included in insurance networks such as Medicaid, CMS/Medicare, Cigna, Aetna, Humana, Blue Cross Blue Shield, and UnitedHealthcare.
Do you want to be immediately credentialed as an authorized healthcare provider to start practicing and billing? Physician credentialing services is a complicated task involving varying verifications and lots of documentation at different stages by the insurance network. A simple error can result in denials, leading to potential revenue loss.
CareCloud MB Medical Billing company is the most reliable company offering the best medical credentialing services. Our professionals are extensively experienced, certified, and trained and effectively handle all your tasks such as source verification and enrollment in premium payer networks.
Our Medical Credentialing Process
An Expertly Designed Medical Credentialing Services
CareCloud MB’s medical credentialing process is not just a routine procedure, but a certified and validated process with unmatched transparency to ensure the highest standard of compliance. We have an exceptional track record of getting healthcare providers approved in premium payer networks in their specific specialties with maximum privileges. Our end-to-end credentialing process includes the
following steps:
Surveying the Provider
Our credentialing specialists conduct extensive research to gather essential data, conduct comprehensive interviews with the providers, and verify data such as educational history, license number, demographics, and professional background.
Choosing The Insurance Company
We strive to strategically choose insurance partners for our healthcare providers whose license type and practice goals are aligned with providers. We also finalize insurance panels based on practice location.
CAQH Enrollment and Management
We take CAQH application submissions into serious consideration, keep credentials current, and manage ProView accounts for transparent primary source verification. We also assist in ensuring quick insurance panel integration, payer credentialing submissions, and accurate profiles that enhance the quality of patient care and network engagement.
Fast Credentialing Approval
Although the typical timeline is between 60 to 120 days our credentialing experts take proactive measures to accelerate the process. Our team keeps interacting with payers every week to ensure swift processing and endorsement of credentialing applications.
In-Network Enrollment
Once your credentialing process is completed, your application enters the contract phase. Here, an in- network contract may be offered, including CPT billing codes and fee schedules. We effectively manage closed panel challenges to ensure your secure inclusion. If you are successfully credentialed, direct billing becomes viable, often with preferred reimbursement rates.
Hospital Privileges Application
As the medical credentialing services procedure wraps up, our involvement persists. We help you in getting all necessary hospital privileges, whether it’s admitting, surgical rights, or courtesy.
Ongoing Monitoring Updates
Our professionals consistently stay connected with insurance companies to ensure that the credentials of your company remain current. Our vigilant and continuous oversight results in getting you credentialed without any interruption. We continuously track your credentialing expiration and conduct weekly reviews to maintain your active status. You can rest assured that your credentials are in responsible hands.
Complete Provider Credentialing Solutions
Offering All Inclusive and Exceptional Medical Credentialing Services
Medicaid and Medicare Provider Enrollment
We enroll healthcare providers in Medicaid and Medicare programs which are the largest insurance programs in the United States, covering millions of citizens in the U.S. Credentialed healthcare providers can expand the spectrum of their patient base by enrolling in these programs. Enrollment in these programs can translate into higher revenue growth.
Commercial Insurance Credentialing
We provide physician credentialing services with commercial insurance payers such as Humana and Aetna, which are private health insurers that offer different networks and plans for their members. By credentialing with these companies, healthcare providers can negotiate better reimbursement rates and access more patients.
NPI Registration (Type 1 and Type 2)
We offer medical credentialing services to individual physicians (type 1) and healthcare organizations by updating their National Provider Identifier (NPI), which is a unique ten-digit number assigned to providers by the Centers for Medicaid & Medicare Services (CMS). NPI is required for reporting, billing, and electronic transactions.
CAQH Registration and Maintenance
By deploying the best technology and talent, we strive to keep our clients ahead of competitors in the industry. Our resilient specialists maintain the profile of every healthcare provider on the Council for Affordable Quality Healthcare (CAQH) ProView, which is an online database collecting and verifying provider information for credentialing purposes. By using CAQH ProView, healthcare providers can refine their credentialing process with multiple healthcare plans.
MCR DMEPOS Enrollment
Healthcare providers using our medical credentialing services can enroll in the Medicare DMEPOS program, which covers items such as oxygen equipment, wheelchairs, braces, and diabetic supplies. By enrolling in these programs, providers can improve their quality of care, offer these items to Medicare beneficiaries, and receive reimbursement from Medicare.
Hospital Privileges
Through our Medical Billing and credentialing services, we facilitate healthcare providers with obtaining and reviewing their hospital privileges, which are the responsibilities and rights granted by a hospital to physicians to practice within its organizations. With hospital privileges, physicians can access hospital resources, admit and treat patients, and collaborate with other healthcare professionals.
Securing High-Paying Contracts for Physicians
Our credentialing experts put extraordinary skills and efforts into negotiating with insurance payers on your behalf, leading to a contract based on terms and conditions agreed by both provider and payer. By negotiating contracts, the medical practitioner can secure a dispute resolution process, favorable payment rates, quality measures, and network inclusion.
Revalidation & Re-Credentialing
Our Medical Billing and credentialing services manage every healthcare provider’s re-credentialing and revalidating enrollment process and credentialing status with Medicaid, Medicare, and commercial insurers. With CareCloud MB handling these processes on autopilot, physicians can maintain their eligibility to participate in these programs and avoid any penalties or interruptions.
Reimbursement Issues Audit
Our privileging and credentialing experts audit reimbursement issues, such as delays, underpayments, denials, or errors from insurance payers. We also provide accounts receivable (AR) follow-up services to our providers to help them collect outstanding payments from payers. By following up on AR and auditing reimbursement issues, physicians improve cash flow, optimize their revenue cycle, and reduce their bad debt.
Physicians State License
Since regulatory requirements and procedures for licensing healthcare providers in each state are different, our extensively experienced professionals help providers effectively obtain and review their state license to practice medicine in the U.S. With obtained and renewed state licenses, providers can adhere to state laws and regulations, demonstrate their qualification and competence, and protect their professional liability.
DEA Certificate & Renewal
CareCloud MB physician credentialing experts help healthcare providers with renewing and obtaining their Drug Enforcement Administration (DEA) certificate, which authorizes them to prescribe controlled substances in the United States. Once they obtain and renew their DEA certificate, which is a registration that authorizes them to prescribe these drugs legally and safely to their patients.
CLIA Registration
Our medical credentialing services include facilitating healthcare providers with registering their laboratory under the Clinical Laboratory Improvement Amendments (CLIA) which are federal standards that regulate laboratory testing performed on human specimens. CLIA registration is required for any laboratory that performs tests for the prevention, diagnosis, health assessment, or treatment of disease.
Best Provider Credentialing Services Near Me
CareCloud MB Offers The Best Medical Credentialing Services In The U.S
Are you looking for the best medical credentialing company in the U.S.? CareCloud MB stands out in the industry as it has hired and maintained highly qualified staff and international standard infrastructure facilities to provide the most sophisticated medical credentialing services.
Our experts start by conducting a thorough assessment of your practice needs the payers you want to work with and the requirements of your state. From there, we avail our extensive payer contracts and relationships to compile and verify all necessary documents, certifications, licenses, insurance, etc. to comply with the distinct criteria of each payer. For instance, when credentialing a healthcare provider in California, we would ensure thorough verification of their medical license with the Medical Board of California, review their malpractice insurance coverage, check for any disciplinary actions on the National Practitioner Data Bank, and collect a current diploma and CV before submitting to health plans
like Health Net and Blue Shield of California.
Additional credentialing services such as expediting credentialing, re-credentialing, and credentialing for locum tenens providers are also part of CareCloud MB physician credentialing services.
