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.
1st Class Reimbursement
Maximize your financial rewards with first-preference reimbursement rates, ensuring higher payments for the same services. Boost your profitability satisfaction effortlessly.
Maximum Privileges
Our streamlined approach ensures you win contracts and secure essential privileges, enabling participation in innovative programs and earning quality performance incentives.
Billing-Ready
Be ready to bill from day one with a unique provider identification number (PIN) for electronic claim submissions and online tracking, saving valuable time.
Swift Reimbursement
Ensure a healthy cash flow with faster reimbursements. Claims are processed within 15 to 30 days, so you don’t have to wait months for payments.
Payer Support
We advocate for you with insurance companies, negotiating on your behalf and resolving issues to ensure fair and timely payments.
Minimize Denials
Our expertise eliminates denials, enhancing your efficiency. We handle eligibility checks, authorizations, and accurate claim submissions to minimize errors.
We champion a provider’s access to prized in-network contracts…
MedClaimAssist provider enrollment services unlock in-network contracts, no matter how exclusive the payor panel.
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Maximum hospital
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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
A Step-by-Step Guide to Our Specialist-Vetted Provider Credentialing
At MedClaimAssist, our credentialing process is designed to ensure the highest standards of compliance and efficiency. With a success rate of up to 98% in securing approvals in premium payer networks, we help providers get maximum privileges in their specialties.
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.
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.
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.
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.
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.
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.
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
Helping Healthcare Providers With All Their Credentialing Needs
MedClaimAssist offers comprehensive provider credentialing services to healthcare professionals and organizations. We streamline the process, ensuring compliance, fast approvals, and seamless integration into top-tier payer networks.
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.
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.
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.
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.
Best Provider Credentialing Services Near Me
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
Credentialing and Payer Enrollment Services For All Healthcare Organizations
Proper credentialing is essential for healthcare providers to deliver quality care, attract patients, and maintain compliance. Our comprehensive credentialing service helps providers of all specialties navigate these challenges. Our payer enrollment credentialing services are available for:
Physicians
Our credentialing service ensures physicians gain swift access to insurance networks, accelerating patient care. It’s crucial for maintaining credibility and trust with patients and peers.
PAs/NPs
Credentialing via our service aids PAs/NPs in expanding their practice reach, ensuring they’re authorized to deliver essential medical services independently.
Hospitals
Credentialing with us streamlines hospital operations, enabling efficient insurance claims processing and fostering collaboration among medical staff.
PT/OT/SLP
Our credentialing facilitates therapists’ inclusion in insurance panels, enabling them to offer vital rehabilitation services while maintaining financial stability.
Podiatrists (DPM)
Credentialing through us empowers podiatrists to offer specialized foot care, securing their position as recognized experts in their field.
Chiropractors (DC)
Our credentialing service solidifies chiropractors’ standing in the medical community, granting them access to insurance networks for widespread patient engagement.
Ambulatory Surgery Centers (ASC)
Credentialing via our service for ASCs enhances patient trust by demonstrating adherence to rigorous quality standards, crucial for safe surgical procedures.
Urgent Care Facilities
Our credentialing ensures urgent care facilities are in-network with insurers, making prompt and affordable medical services accessible to a broader range of patients.
Diagnostic Testing Facilities
Credentialing helps diagnostic facilities and clinical laboratories gain insurance approval, increasing patient referrals and enabling prompt diagnosis and treatment.
Optometrists, Audiologists
Credentialing broadens the reach of optometrists and audiologists, allowing them to deliver essential eye & ear care services to a more diverse clientele.
Behavioral Health Providers
Our credentialing service aids behavioral health providers in becoming part of insurance networks, enabling vital mental health services to reach those in need.