Provider Credentialing

As a revenue cycle management (RCM) company we understand firsthand the impact provider credentialing has on cash flow to your organization.

Provider Credentialing Services

Delays or lapses in the credentialing process can cause reimbursement to be delayed or even denied.

Trying to understand and manage credentialing is a tedious and time-consuming endeavor that rapidly consumes staff resources. Understandably so, most medical practices lack expertise in this area because it is a function that is not performed often. Med USA is a full-service RCM firm and employs healthcare credentialing experts who can help you complete each phase of the credentialing process accurately and without delays.

Our experts will compile your paperwork and get your credentialing started early. We will put your application through a rigorous review process to certify accuracy before submission. Throughout the credentialing process we will provide the necessary follow-up to ensure your application is being processed as smoothly and quickly as possible.

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Med USA:
Your Medical Credentialing Partner

These requirements can be complicated, and a lack of experience or a lack of the appropriate tools and proactive monitoring, can work against your business and negatively affect reimbursement. In the beginning, these effects may be difficult to notice, but they become obvious with the appearance of claim denials and delayed or decreased payment due to out-of-network issues. Increasing government regulations, payer-specific requirements, and a general lack of industry standardization in this area all contribute to provider credentialing being difficult and time-consuming. Med USA offers both payer contracting and provider enrollment, as well as primary source verification and privileging. Our proprietary process and experienced specialists will handle every step for you to become an in-network provider and maintain the required enrollment, licensing, and privileging through our provider credentialing services.

Our Specialties

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Provider Credentialing Services

  • Participating and Non-Participating Payer Sweep
  • Credentialing/Contracting Payer Enrollment
  • Entity Routine Application Follow-up and Updates
  • NPI and Payer Provider ID Numbers
  • Re-Credentialing, Re-Appointments & Renewals
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Expirable Document Management Services

  • Pro-Active Monitoring and Notification of Expiring Documents as a Medical Credentialing Service (e.g., Professional License, DEA, Board Certification).
  • Notifying and maintaining up to date data and documents, including their expiration dates.
  • CAQH Re-Attestations (every 120 days).
  • Maintaining all important documents and attestations, notifying and re-issuing every 120 days.
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Re-Credentialing Services

  • Managed Based on Individual Player Requirements
  • Application and Signature Page Consolidation and Management
  • Applications Sent and Tracked to Confirm Delivery and Receipt
  • Regular Application Follow-Up and Updates
  • NPI and Player Legacy Provider ID Numbers Consolidation
  • Medicare Revalidation
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Customized Credentialing Solutions

Med USA supports both newly graduated physicians and more experienced ones through our personalized and customized Provider Credentialing Solutions Services. We create customized solutions that allow us to consult, supplement, or provide fully managed credentialing services for your practice. Our team is highly trained and able to step in, analyze, and provide resourceful recommendations for your practices, then complete all the required applications and documentation. Our services are available to all medical professionals, including group practices, hospital-based physicians, non-physician practitioners, and laboratories.

Some of the customized solutions we offer include:

  • Initial Hire Form and Enrollment Design
  • Provider/Group Enrollment Assessment
  • CAQH Maintenance and Updates
  • Medicare and Medicaid Enrollment
  • Out-of-State/Regional Payer Enrollment Services
  • “Change-To” Address Services
  • Facility Address Update/Change Services

Testimonials

New Provider Credentialing Services

One of the most frustrating aspects of provider credentialing for new providers is the number of requests they receive from staff who are inexperienced with how the credentialing process works. New providers and their staff often lack experience about the information required to complete credentialing applications.

Med USA has developed an efficient on-boarding and collection process through our proprietary tool to facilitate the healthcare credentialing service for new providers as quickly and painlessly as possible. Our process encompasses the collection of provider data, supporting documentation and signatory needs which gives us everything to complete applications and submit in a timely manner.

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Begin the Medical Credentialing Process Early

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Begin The Medical Credentialing Process Early

It is best to start any process as early as possible. Credentialing can be a long process and can take up to 90 days or longer depending on each payer’s timelines.

Lately, more payers have lengthened their timelines considerably and have been expanding their enrollment requirements to include Non-Physician Practitioners (NPP). Med USA Provider Credentialing consist of a time-tested proprietary process and a highly trained team ready to help support you through the navigation of the complicated maze of provider enrollment and credentialing. We can help you enroll a new hire, transition from one practice to another, or even set up enrollment to a new group. We will take care of the details so that you can take care of your patients.

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The Details Matter

We Worry About the Details, So You Don’t Have To

  • Ensure information on payer applications is accurate and legible
  • Documentation review
  • CV detail review
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Stay Up To Date

Med USA Helps You Stay Up To Date and Current On:
  • Expiration Dates on Licenses and Other Documents
  • CAQH Profile + CVs – Maintain, update, and re-attest provider CAQH profiles and CVs.
  • Privileges at Affiliated Hospitals and Facilities – Help providers obtain privileges at affiliated hospitals and other facilities.
  • Re-Attestations – Re-attestation to maintain participation, meet enrollment requirements and keep all data and information up to date.
  • CME Hours
  • Board Certifications

Reach out to see how our team can help!

Optimize Your Practice Today

There are no long-term commitments for Med USA’s Credentialing Services and pricing is usually done on a simple to understand per application or per task basis.

 

Testimonials

Professionals like you are talking about Med USA

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