Understanding the Medical Credentialing Process
Medical credentialing is a systematic process of gathering and verifying a physician’s professional records to confirm their qualifications and eligibility to practice medicine. This process includes verifying hospital privileges, malpractice insurance, education, board certification, professional references, and other pertinent information.
Organizations must perform primary source verification of a practitioner's education, training, certifications, provider type, and licensure, maintaining a comprehensive file on each provider. To facilitate this, providers must grant permission to investigate their background and professional credentials. Provider enrollment applications are a crucial part of this process, helping to determine a physician’s eligibility for medical practice.
Physicians must be credentialed for their specific scope of practice, including the procedures and equipment they will use. The standard credentialing process typically takes 3 to 4 months, with the application and approval process taking around 90 days.
Steps in the Credentialing Process
Analyze Network Needs : Determine the primary payers for your network.
Execute a Contract Formalize the agreement for credentialing services.
Document Collection: Gather necessary documents from the provider and obtain contact lists from insurance companies.
Application Submission: Confirm receipt of the application by the insurance companies.
Notification: Inform the provider of the executed documents so they can begin claim submission.
Benefits of Our Credentialing Services
When choosing an outsourced credentialing company, it is essential to select a team that will represent you effectively and understand your needs and goals. At Tower Physician Solutions, we offer: - Trustworthy and Reliable Services: We commit to providing some of the best response times in the industry to enhance your revenue. Whether you are starting a new practice or expanding an existing one, we expedite credentialing with necessary payers.
We also handle enrollment for community hospital providers and various specialties, including dental practices.
- Transparent Communication: Our team maintains consistent communication throughout the process, ensuring all necessary details are covered and preventing setbacks.
- Reduced Administrative Burdens: We help you achieve clinical excellence and patient satisfaction while meeting financial and operational objectives. Our team handles credentialing and enrollment, allowing you to focus on patient care and business growth. You receive bi-weekly updates and a post-credentialing resources book with essential forms for future credentialing or revalidation.
Choose Tower Physician Solutions for a streamlined, efficient credentialing process that minimizes delays and supports your practice's success.