Credentialing, Contracting, And Privileging
BIS provides a comprehensive solution for credentialing, contracting, and privileging services. Our team streamlines the entire process to effectively navigate the complexities of verifying qualifications, establishing contracts, and granting privileges. Our solution ensures regulatory compliance, reduces administrative burden, and accelerates the onboarding of qualified professionals, ultimately driving operational efficiency.
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Intro
A first phase of Credentialing is the process of obtaining, validating and assessing the qualifications of the physician or provider to render services in or for the health care organization and proceed connecting the physician or the provider with a pertinent insurance carrier. Physician credentialing services cover all aspects of healthcare and related services to ensure that standards are maintained, no matter what.
Presently, as there are already a huge number of medical practitioners operating, the insurance team is quickly being overloaded and are slowed down to welcome any new healthcare providers. This is where they can opt for efficient credentialing services to be relieved from the nerve-racking process of medical credentialing and focus on the patients care smoothly. Credentialing is the basic key factor in Revenue Cycle Management (RCM).
A crucial step in revenue cycle is the procedure of connecting the physician or the provider with the payer referred to as Provider credentialing. Providing quality service to the patients would be the primary goal of any healthcare organisation. At the same time, they must be secure financially as to maintain a robust revenue cycle which would steer them towards a flourishing practice.
Business Integrity Services offers you the best provider credentialing services with our proficient and well experienced team in handling all the procedures and regulations of the industry thus steering you to attain optimum and swift outcomes.
Provider Credentialing Services
Our provider physician credentialing services comprises a thoroughly informative customer support team who are very helpful in providing a comprehensive service, thereby making your practice successful. We gear up your administrative tasks and manage all requirements in documentation. Through proper guidance of documentation, we help you engage in multiple Insurance provider networks.
- This extensive process involves the following steps:
Offer assistance with the evaluation of application and help with the total documentation - To assist the medical provider with the process of verifying the qualifications
- Implementing CAQH ( Council of Affordable Quality Healthcare ) registration for a physician or provider and maintaining attestation on well-timed
- The document filing in par with the current requirement for Government Enrolments, Hospital Classified services, Licence expiry, Panelling of the Health Plans and assisting in acquiring the missing documents is completely covered by us
- Handling delegated physician or provider credentialing with payer
- Managing the escalated physician or the provider’s payer credentialing on timely
- Keeping track on the validity as well as regularly update the necessary documents filing, We are focused on helping the medical providers to be relieved of stress and reduce the time spent on all these difficult procedures
- Handling crucial database with complete data entry, periodic updates on the provider information according to the standard procedures and policies are maintained by us
Provider Enrollment Services
Provider Enrollment Services plays a key role in allowing the practices to obtain enrollment for all their provided services while making sure that the payers have the necessary data for processing the claims for your services administered. Our provider enrollment services strive diligently to see you through this procedure by allowing you to:
- Frequent and instant update and validation on the Provider’s address details.
- Enroll for the various types of electronic transactions required
- Be ensured that proper verifications are being done for the provider information and ensure that the payers have the right information prior to any submission of claims.
- To receive updated status information pertaining to the provider enrollment services.
Importance of Physician Credentialing Services
When a new physician begins the medical practice, credentialing needs to be considered seriously and not deferred as it would be a roller coaster ride with mounting cash flow delays and other things of concern. The Physician needs to be enrolled and get attestation to be a part of the networks covered by the Payer in order to provide services for those patients who hold membership in the Payer’s plans. By outsourcing an effective medical credentialing Services, the revenue generations is splendid and unnecessary delays are avoided.
Business Integrity Services has a comprehensive knowledge and 100+ years of integrated experience thus providing maximum level of customer satisfaction. Hence we will be your trustworthy companion in providing extensive physician credentialing services helping you to minimize the cost and maintain the quality.
- We conduct a careful examination of the physician’s license, qualification, expertise, adequate training requirements, residential details and any other significant certifications in order to meet the Payer’s standards. Our stalwart and experienced team of professionals prepare as well as oversee the credential applications for procuring a continual prompt and trouble-free process.
- Business Integrity Services has exclusive medical credentialing service experts who are highly knowledgeable in assisting the physician whenever there is a need of authorization for the referrals and undertake the essential steps in acquiring the same.
- We can assure that our physician credentialing services are well organised to enhance easy preparation and submission of the forms depending on the terms set by the Payer or Insurer. We consistently manage the entire documentation and do regular routine checks on the expiry date of the Licensures, Liability insurance (COI), NYS-registration, CLIA registration, DEAs and MA registrations. This helps to ensure if re-application of the registration is required and get it done. Thus, we help you to save unnecessary waste of precious time, resources and the cost of the hospital.
In the current scenario, it is a huge challenge for the healthcare organisations to sustain and generate good revenues amidst the competition. Hence to attain best outcome it is highly recommended to adopt an efficient outsourcing strategy. Business Integrity Services is happy to serve you to see you through a complacent credentialing process providing you with favourable benefits and prospective growth.