CREDENTIALING

Our credentialing staff has experience crednetialing all different levels of physicians and practitioners ranging from psychiatrists, general practitioners, internists, nurse practitioners, etc.

We have also have vast experience in the area of behavioral health credentialing. We understand the ins-and-outs of the different ranges of credentialing from LPCC's to LISW's along with psychiatric nurse practitioners and psychiatrists.

Credentialing is a multi-step process that can be summed up as follows:

• We collect all of the providers information which includes, but is not limited to, all personal information, copies of all licenses, diplomas, certificates, etc., resumes, all pertinent practice information from current and past employment, along with many other pieces of information.

• A book is compiled for each individual provider that includes of all the collected information. From that point on, each new piece of information, including copies of applications, effective dates, and any and all contact with insurance companies compile the book.

• Once all information is collected, the process of filling out credentialing forms is started. Depending on the many circumstances involved, this step takes anywhere from 3-10 days.

• Once all forms are filled out, copies are made and the ones that need signatures are mailed to the providers to be signed and either mailed in or sent back here to be mailed. The remaining forms that do not need signatures are mailed out to the insurance companies.

• Some insurance companies send other forms and contracts to be filled out and signed after the initial step. These are filled out and any forms or contracts that need signed are once again sent to the provider to sign and send.

• Once a provider is approved, a copy of their approval is sent to them directly and the original is kept in the provider credentialing book.

• We continue to do followup credentialing and also keep everything up to date.

 

INSURANCE COMPANIES

                    1. CAQH
                    2. Medicare
                    3. Medicaid
                    4. Medical Mutual
                    5. Anthem Blue Cross Blue Shield
                    6. Buckeye
                    7. Caresource
                    8. Aetna
                    9. Kaiser
                    10. Summacare
                    11. ValueOptions
                    12. Aultcare
                    13. Worker's Compensation (BWC)
                    14. Hometown
                    15. Cigna
                    16. UFCW
                    17. Humana
                    18. Magellan
                    19. Secure Horizons
                    20. United Healthcare
                    21. United Behavioral Health
                    22. United Mine Workers
                    23. Unison

 

PRICING

The cost of credentialing is $100 per insurance company, per provider. It is also $100 per insurance company for group credentialing.

There is a small yearly fee per provider for the upkeep of all credentialing.

LARGE OFFICE? Call now to find out group rates!!