Credentialing

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CREDENTIALING

Access The Best Technology And Experienced Professionals

Medical credentialing is a critical component of patient safety and quality healthcare delivery. It helps to ensure that healthcare providers are qualified, competent and follow established ethical and professional standards. Credentialing is essential for healthcare institutions and insurance companies to establish networks of trusted providers and to protect patients from receiving substandard care. It also plays a crucial role in verifying that providers are eligible for reimbursement from insurance companies, which is essential for their financial viability.

As a provider or practice manager, it can be difficult to manage this time-consuming process. Bright Ideas Medical Consulting is pleased to offer credentialing in all 50 states so you can spend more time caring for your patients. With advanced technology and experienced professionals, you can rest easy knowing this process is taken care of.

WHY CHOOSE CREDENTIALING SERVICES AT BRIGHT IDEAS MEDICAL CONSULTING? 

The most successful practices recognize that medical credentialing is an important step in healthy revenue cycle management. Regardless of whether you are adding another provider or opening a healthcare practice, the process needs to begin early to keep away from possible issues. It is important to remember that it takes at least 90 days to credential a new provider, and can sometimes take even longer for some insurance companies. Between caring for patients, managing team members and trying to juggle other administrative processes, it can be difficult to find time for this process. Barriers that medical practice managers and providers may face include:

  • Communication: To credential a new provider requires communication with several different parties. Attempting to communicate with these different parties while simultaneously managing your patients and team can lead to key steps in the process slipping through the cracks.

  • Time: This process is both time-sensitive and time-consuming. It is time-sensitive in that it must be completed before a provider begins seeing patients, and time-consuming in that the earliest possible timeframe in which it can be completed is 90 days.

  • Organization: Between the various documents, applications and various communication channels, it is easy for this process to become unorganized.

  • Meeting deadlines: It is important to meet each deadline throughout the process in order to credential a provider in a timely manner.

At Bright Ideas Medical Consulting, our team can take this process off your plate. We house all providers’ data in an encrypted database and keep information safe and secure and manage each step of the process for a smooth transition.

THE CREDENTIALING PROCESS

At Bright Ideas Medical Consulting, we can oversee all steps of the process so you don’t have to. In order to credential a new provider, we follow these steps:

The first step is to gather all important documentation, including medical licenses, W9, Curriculum Vitae, board certification, malpractice history and more.

Once documentation has been collected, we complete all necessary paperwork with the Council of Affordable Quality Healthcare (CAQH), which enables provider information to be stored in a secure database, and makes it so insurance payers can access this information.

We then strategically select top insurance payers for which the provider’s practice submits claims.

We submit the application on your behalf, ensuring everything is correct and complete.

Once submitted, we follow up to ensure the application was received and determine if any additional information is required.

Finally, we receive approval from the insurance payers and communicate the date on which providers’ eligibility begins to the billing department.

Benefits Of Credentialing

There are several benefits to choosing Bright Ideas Medical Consulting for your credentialing needs. Benefits include:

  • Ensure quality assurance

  • Maintain patient safety

  • Prevent losing revenue

  • Increase your patient base

  • Improve your practice’s reputation

  • Enhance the hiring process

  • Reduce administrative burden and team turnover

  • Deliver a competitive edge

Do you think you could benefit from credentialing services at Bright Ideas Medical Consulting? Let’s connect. Fill out our online contact form or call or text (804) 774-1028 to get started.

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