Physician Medical Credentialing Services
Ensure accurate gathering and verification of multiple credentials such as medical licenses, board certifications, and educational backgrounds of healthcare providers with A1mca’s medical credentialing services. Our experts adhere to stringent regulatory standards, often set by authorities such as the Joint Commission and the National Committee for Quality Assurance (NCQA), and help you avoid errors that can lead to penalties and delays in provider enrollment.
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Physician Medical credentialing is a critical process that verifies healthcare providers' qualifications, professional backgrounds, and competence to ensure they meet the necessary standards for delivering care. This broader process of credentialing applies to healthcare providers such as Nurse practitioners (NPs), Physician assistants (PAs), Registered Nurses (RNs), licensed practical nurses (LPNs), Psychologists and Therapists, Chiropractors, Allied Health Professionals, pharmacists, etc.
An effective medical credentialing process involves gathering and authenticating a wide range of documents, including medical licenses, board certifications, educational background, residency training, and work history. Credentialing also involves verifying malpractice claims or disciplinary actions and ensuring the provider meets state and federal regulatory standards.
Despite its importance, medical credentialing poses several challenges for healthcare practices. One significant difficulty is the time-consuming nature of the process, which can take anywhere from 60 to 120 days or more. This delay can be detrimental to healthcare practices, especially if new providers wait to begin work or enroll with insurance payers.
Furthermore, a need for extensive documentation and adherence to numerous regulations, such as those from the Council for Affordable Quality Healthcare (CAQH) and the Medicare Provider Enrollment, Chain, and Ownership System (PECOS), double the difficulties. Likewise, inaccuracies in Primary Source Verification (PSV) or delayed provider enrollment also lead to compliance issues and delays in provider approvals, affecting patient care and reimbursement.
At A1mca, with over 24 years of experience, we specialize in delivering comprehensive medical credentialing outsourcing services for healthcare providers of all sizes. We follow a well-structured workflow to ensure accurate credential verification and timely provider enrollment. Our services cover all key aspects, including primary source verification (PSV), provider enrollment, recredentialing, and ongoing monitoring.
We utilize advanced credentialing systems to efficiently verify, organize, and track essential provider information, from educational backgrounds to licensure statuses. Our expert credentialing services extend to compliance management with regulatory standards, conducting thorough background checks, and ensuring timely submission of documentation for payer enrollment.
Our physician credentialing service experts implement rigorous quality control measures to maintain accuracy and efficiency in all credentialing tasks. By reducing administrative burdens, we allow swift and precise credentialing and help you focus on delivering high-quality care. We also follow strict security protocols to protect sensitive provider information, ensuring peace of mind and exceptional service.
Our Comprehensive Physician Medical Credentialing Services
The Invensis Advantage for Revenue Cycle Management Services
As an HIPAA-compliant outsourced revenue cycle management company, we have over 24 years of experience delivering healthcare revenue cycle management services to US-based health care practices. We have helped our clients adopt best practices, including prioritizing patient care, investing in advanced technology, collecting patient payments upfront, ensuring accurate charge capture, and timely claims filing. Over the years, we have seamlessly integrated people, processes, and technology to adapt to evolving legislation and industry needs. As a result, our RCM management services have helped our clients to eliminate waste, enhance efficiency, and receive comprehensive, value-based support. Our expertise has led to significant success for our clients, including a 20% reduction in claim denials and a 30% increase in collection rates. Outsource revenue cycle management services to us and reap the maximum benefits of back office support services.
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