What is Medical Credentialing?

For healthcare providers, medical credentialing is the process of getting networked with insurance companies (this is often described as "getting on insurance panels"). This then allows healthcare providers to accept insurance and get their clients the healthcare that they need.

Medical credentialing is a popular term among healthcare providers these days, especially among counselors, chiropractors, and even massage therapists who only a few years ago were able to run "cash-only" practices. In contrast, today these providers are finding that patients and clients are demanding that they accept their insurance for payment (this is often referred to as "third party payments," another buzz word).

Completing one's medical credentialing process involves...
  1. Retrieving and filling-out a series of applications with insurance companies. Trust me, this will take way longer than you expect. You will surely spend at least 10 hours or so filling out an application for each company you wish to get credentialed with.
  2. Submitting the applications to insurance companies. This sounds fairly simple, but will also take more time than you think. Once you've submitted your application to each company, you need to call to make sure they received your application. It's very possible that your application ends up in the wrong hands and gets tossed aside—you need to jump in ASAP if this happens.
  3. Doing a lot of follow up. Your calls don't stop after you've made sure that your applications were received. Now, you have to continue following up with the companies to check in on their progress. It happens again and again: an application hits a snag. Say the insurance company is trying to get in tough with your college to double check that you actually graduated from said college, but they never hear back; your application is now in limbo. And you need to intercept.
Healthcare providers often describe the process to be "nightmarish" as the application process rarely goes smoothly, and many providers find themselves resubmitting applications, fighting enrollment rejections, and spending a lot of time "on hold" with insurance companies. Fortunately, you can avoid this nightmarish process by letting us do it for you.

Our credentialing team is here to help take the stress out of the credentialing process. Let us help you get on insurance panels. Give us a call at 1-855-664-5154 for more information.



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