Medical Credentialing Services
Get rid of your credentialing woes and get enrolled with great efficiency
Sybrid MD’s Physicians Credentialing Service is a crucial step to avoid delayed submission of healthcare claims, crossing filing limits, wastage of time and loss of revenue. Credentialing process is managed by our experienced team that help you navigate the process of provider enrollment and MD credentialing.
Our Medical Credentialing Services Include:
Credentialing & Re-credentialing
We obtain eligibility verification from insurance companies prior to the patient’s appointment. This ensures that there are no insurance denials.
Dedicated Team
A team that completes the credentialing details and submits it to commercial Insurances, Medicare and Medicaid, as requested by healthcare physicians.
Compliance
Sybrid MD’s Physician Credentialing Services ensure compliance with the National Committee for Quality Assurance (NCQA) and the Department of Health and Family Services (DHFS.
Crucial Follow Ups
Our medical billing and credentialing services ensure that all follow-ups are performed properly for a smooth enrollment.
Portal Registrations
Create and update CAQH & PECOS credentialing portals
Contracting Issues & Data Integrity
We resolve contracting issues and maintain data integrity through audits
Credentialing: Did you know?
1
Medical credentialing services usually involves gathering information about the physician’s background and qualifications through a formal application that is verified against reliable sources like the National Practitioner Data Bank or the American Board of Medical Specialties.
2
The Coalition for Affordable Quality Healthcare has offered a uniform MD credentialing program for about 15 years, and this program has been adopted by most payers in the United States.
3
Typically, when contacted by a hospital, HMO, or employer, physicians are required to answer 800 questions. Information includes items ranging from licensure to practice history in the last five years
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Medical Billing and Credentialing Services
For a healthcare professional, finding the best medical billing and credentialing services is a daunting task. The service provider a healthcare professional chooses would determine whether there’s peace of mind ahead or disturbance. Although there are various credentialing companies around the world – each claiming to be the best; but finding the right service would require doing some research. At SybridMD, we provide medical billing and credentialing services tailored to your specific needs and requirements, so that you can focus on doing what you do best – helping people live the healthiest lives possible.
Why does a Physician need Credentialing Services?
Certainly, physicians can do this themselves – but a professional physician credentialing service would remove all the hassles from the equation. You can easily spend more time doing something you love while a professional credentialing service for physicians like SybridMD do all the hard work for you. We have helped many healthcare professionals with our unrivalled medical billing and credentialing services and we are ready to help you too.
FAQs
The credentialing process takes around 90-120 days and sometimes the process completes quicker if the documents are complete and there are no objections.
To speed up the credentialing process you must proactively gather the required documents, hire a credentialing services provider and ensure accuracy of the information provided.
The good thing about Medicare is that the day they receive the application, providers can bill from that date. Medicare takes 60 – 90 days to complete the credentialing process and sometimes the turnaround time is just 15 days.
The insurance companies take between 60 – 90 days to verify the provider’s educational documents, qualifications, past work experience, and checking the criminal record.
Credentialing is needed to get physicians enrolled with the insurance company. Without credentialing, providers cannot claim insurance companies for reimbursements? Credentialing determines the eligibility of the providers.
Payors usually review provider agreement every 3 years to ensure and most of the organization requires complying with the re-credentialing to ensure provider network quality.
The credentialing process can take up to 3 months to complete. Every organization has a different process to vet the sign-up application and usually, an in-house committee scrutinizes the application form every angle.
The provider credentialing is a process of authenticating the accuracy of provider’s educational documents, career record, malpractice history, licenses, diplomas, certifications, and professional references upon hiring. Providers must be credentialed with the payors and insurance companies to get paid and the process includes NPI and CAQH ProView.