Credentialing

Get Credentialed & Enrolled. 2X Faster and Easier!

MedClaimAssist is a leading Provider Credentialing Service provider. Our expert solutions remove administrative burdens, unlock privileges, ensure seamless network integration, and speed up reimbursements. Trusted by doctors, nurses, and therapists, we help healthcare professionals thrive in their careers.

We champion a provider’s access to prized in-network contracts…

We Enroll Providers in Premium Payer Networks Quickly and Efficiently!

Credentialing, also known as insurance or doctor credentialing, verifies a healthcare provider’s qualifications, ensuring compliance with licenses, certifications, and state and federal regulations. It enables providers to practice in specific facilities and receive payments from major insurance networks like CMS/Medicare, Medicaid, Aetna, Cigna, and others.

Fast credentialing is vital for providers to start practicing and billing ethically, but the process is complex, requiring extensive documentation and precise verification. Even minor errors can lead to delays, denials, and wasted resources.

At MedClaimAssist, we simplify credentialing. Our experts manage every step, from primary source verification to enrollment in top payer networks, ensuring a smooth, timely, and cost-effective process.

Our Medical Credentialing Process

1

Surveying the Provider

Our credentialing process starts with a thorough survey conducted by our experts. This step involves interviews with providers to collect crucial information such as license numbers, educational history, professional background, and demographic details.

2

Choosing the Insurance Company

We guide providers in selecting the right insurance partners aligned with their practice goals and licenses, ensuring a strategic choice of insurance panels based on the provider’s location and specialization.

3

CAQH Enrollment and Management

We handle CAQH application submissions and ProView account management, ensuring credentials are up to date for efficient primary source verification. Our team also supports payer credentialing submissions to expedite insurance panel integration and ensure accurate profiles.

4

Ensure Fast Credentialing Approval

While the standard process takes 60-120 days, we speed up the timeline by proactively engaging with payers. Our team follows up weekly to ensure rapid processing and approval of credentialing applications.

5

In-Network Enrollment

Once credentialing is complete, we assist with the contract phase. This includes negotiating in-network contracts, securing fee schedules, and addressing closed panel challenges through appeals, ensuring smooth integration into networks and maximizing reimbursement rates.

6

Winning Hospital Privileges

As the credentialing process concludes, we also help secure necessary hospital privileges, including admitting, courtesy, and surgical rights, ensuring providers can fully serve their patients.

7

Ongoing Monitoring and Updates

We continuously monitor and track credentialing expirations, conducting daily and weekly reviews to ensure that credentials remain current. Our team handles renewals, giving you peace of mind and uninterrupted status.

Complete Provider Credentialing Solutions

Medicare and Medicaid Provider Enrollment

We enroll providers in Medicare and Medicaid, the largest health insurance programs in the U.S., offering coverage to millions of Americans. By joining these programs, providers expand their patient base, increase revenue, and ensure compliance with federal and state regulations.

Commercial Insurance Credentialing

We assist providers in credentialing with leading commercial insurers like Aetna, Humana, and others, providing access to private health plans and networks. Credentialing with these insurers helps providers broaden their patient reach and negotiate better reimbursement rates.

NPI Registration (Type 1 and Type 2)

Our credentialing services include obtaining and updating National Provider Identifiers (NPI) for individual providers (Type 1) and organizations (Type 2). The NPI, a 10-digit number issued by CMS, is essential for billing, reporting, and electronic transactions, ensuring seamless operations for healthcare providers.

Get credentialed and enrolled 2x faster.

CAQH Registration and Maintenance

We help providers stay ahead of the competition by managing their profiles on the Council for Affordable Quality Healthcare (CAQH) ProView. This online database simplifies credentialing by collecting and verifying provider information for multiple health plans. With CAQH ProView, providers streamline their credentialing process across various insurers.

MCR DMEPOS Enrollment

Our credentialing services also include enrollment in the Medicare DMEPOS program, which covers essential items like wheelchairs, oxygen equipment, and diabetic supplies. By enrolling, providers can offer these items to Medicare beneficiaries, enhance care quality, and secure Medicare reimbursement.

Hospital Privileges

We assist physicians in obtaining and renewing hospital privileges, which grant them the right to practice within hospital facilities. Hospital privileges allow providers to admit and treat patients, access hospital resources, and collaborate with other healthcare professionals for comprehensive patient care.

We activate high-paying contracts for providers.

Contract Negotiation

Our credentialing team provides support to the doctors with negotiating contracts with insurance payers, which are the agreements that define the terms and conditions of the provider-payer relationship. By negotiating contracts, medical practitioners can secure favorable payment rates, dispute resolution processes, quality measures, and network inclusion.

Revalidation & Re-Credentialing

Our medical insurance credentialing service manages every physician’s revalidating and re-credentialing enrollment process and credentialing status with Medicare, Medicaid, and commercial insurers. With BellMedEx managing these processes on autopilot, providers can maintain their eligibility to participate in these programs and avoid any interruptions or penalties.

Reimbursement Issues Audit

Our credentialing and privileging specialists audit reimbursement issues, such as underpayments, denials, delays, or errors from insurance payers. Providers also get accounts receivable (AR) follow up services to help collect outstanding payments from payers. By auditing reimbursement issues and following up on AR, providers can improve their cash flow, reduce their bad debt, and optimize their revenue cycle.

Meet payer requirements for quick enrollment.

Providers State License

We assist providers with obtaining and renewing their state license to practice medicine in the US. Each state has its own requirements and procedures for licensing health care providers. By obtaining and renewing their state license, providers can comply with state laws and regulations, demonstrate their competence and qualifications, and protect their professional liability.

DEA Certificate & Renewal

BellMedEx medical credentialing experts help providers with obtaining and renewing their Drug Enforcement Administration (DEA) certificate, which is a registration that authorizes them to prescribe controlled substances in the US. By obtaining and renewing their DEA certificate, providers can prescribe these drugs legally and safely to their patients.

CLIA Registration

Providers using our physician credentialing services get help 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 diagnosis, prevention, or treatment of disease or health assessment.

Get credentialed with maximum privileges.

MedClaimAssist Offers The Best Credentialing Services Near You In The USA

Looking for the best credentialing solutions by credentialing specialist companies near you? With over a decade of experience, BellMedEx is the best provider credentialing company for practices across all 50 states of the USA. 

We start by thoroughly assessing your specific practice needs and the requirements of your state and the payers you want to work with. From there, we leverage our extensive payer contracts and relationships to compile and verify all necessary documents, licenses, certifications, insurance, and more to meet each payer’s distinct criteria.

For example, when credentialing a physician in California, we would verify their medical license with the Medical Board of California, check for any disciplinary actions on the National Practitioner Data Bank, review their malpractice insurance coverage, and collect a current CV and diploma before submitting to health plans like Blue Shield of California and Health Net.

Additional credentialing services like re-credentialing, expediting credentialing, and credentialing for locum tenens providers are also a part of BellMedEx Provider Credentialing and Enrollment Service offerings.

Payer Enrollment and Medical Credentialing for Doctors

Don’t let the red tape stop your pace.

Credentialing can be a hassle, but not with us. We have the skills, the tools, and the connections to get you credentialed and enrolled with any payer you want. No matter what your specialty or location, we will enable you enjoy the benefits of being in-network!