Credentialing involves verifying a provider's qualifications in order to ensure that he or she is capable of providing patients with care. Several health insurance companies require this process in addition to hospitals and surgery centers. A number of these plans are available through CMS/Medicare, Medicaid, and commercial insurance providers. During the verification process, all documentation pertaining to the provider is verified to ensure that it is valid and current. A medical license, malpractice insurance, and DEA registration are some of these requirements.

Credentialing requires the following additional information:

• Internship/Residency/Fellowship Information
• Curriculum vitae of the provider
• Medical School information
• Certifications by boards

Advanced healthcare credentialing services, we can assist you with provider enrollment and becoming an in-network provider so that you can receive reimbursement from each carrier. While just a few years ago healthcare professionals considered medical credentialing services “optional” for building a practice, today it has become more necessary than ever for providers to be in-network with insurance companies. Learn how PrognoCIS can help you get the proper credentials to open a medical practice. In order to enable you to become an in-network provider with the insurance carriers that you wish to partner with, the credentialing team provides knowledgeable and comprehensive service. In the event that you need guidance in your specialty and service area, we can provide recommendations based on our analysis.

Additionally, we provide a variety of services to existing practices. It is necessary to recertify physicians every three to five years in order to maintain credentialing. It is our intention to provide you with a service that will perform re-certification for you, notify you if your documents are about to expire and maintain your profile with the CAQH. Contact us once you have gathered all your documentation and are ready to begin. In addition to solo practitioners, we also work with practices with 30 or more providers, as well as practices with one or two providers. A number of specialties and services, including DME, are covered by our team of professionals.

In Advanced Healthcare, our team of professionals maintains expertise in the credentialing process for healthcare providers. In addition, it is necessary to remain informed about industry changes, credentialing trends, and payer requirements. Our team of experts manages the entire credentialing process from beginning to end. Therefore, our team assumes all of the responsibilities normally carried out by your staff, allowing you to devote more time and energy to more important tasks.After collecting all required documents, we complete the credentialing process, send applications to payers, and promptly respond to payers' requests for clarification. Each time your practice is due for re-credentialing, Advanced Healthcare assigns a team of experts to track the deadlines, initiate, and complete the process.

In order to complete the initial application, our team works with the provider. Among other tasks, we perform primary source verification, background screening, as well as coordinating with payers to support timeous approvals and expedite the start of new providers