Nurse Credentialing

Offers Expert Medical/Insurance Credentialing for Nurses

As a nurse, the center of your attention is helping clients. Each day brings a variety of situations and challenges, and your focus is ensuring outstanding service to the individuals who walk through the door.

With days filled and devoted to clients and the many other responsibilities related to the practice, there is little or no time left for the exhausting process of medical credentialing. With barely a minute to take a break, it would be close to impossible to carve out time to fill out piles of paperwork, make phone calls to ensure applications have arrived and are being processed, and spend valuable minutes on hold with insurance companies. In addition to following up on the applications, there are deadlines to meet, and in the event that paperwork is lost or too much time has passed, the deadline may have expired. Medical credentialing takes an extensive amount of time, and you probably do not have any extra to spare.

The experts at Credentialing.com can relieve you of the endless frustrations of medical credentialing, giving you the time and energy you need to provide the care your patients and clients deserve.

The team at Credentialing.com resolves the issues of medical credentialing. They manage the process from beginning to end and every detail in between. With years of knowledge and experience, the team at Credentialing.com can help you avoid the stresses of paperwork and time spent on the phone with insurance companies.

The Importance of Medical Credentialing

Accepting Insurance is Integral

Medical credentialing is crucial for nurses, whether starting or maintaining a practice. While many experienced healthcare providers have achieved success with cash-only techniques, they now find it necessary to obtain medical credentialing. Getting on insurance panels or becoming ‘in network’ with insurance plans is important because healthcare in the country is more universally accessible. Being on insurance panels allows practitioners to be eligible to accept third-party payments from new and potential patients, which is an integral component of growing the practice.

Patients Request Covered Services

Due to healthcare reform, many practitioners who previously accepted cash-only payments are now serving more people with insurance plans. The cost of healthcare is rising. HMO plans have become more prominent than PPO plans, making out-of-network benefits obsolete. Additionally, healthcare has become more equitable, making it possible for services to be covered whether the condition is new or pre-existing.

Patients today are not hesitant to ask if their insurance is accepted—they require it. In the past, patients were willing to pay out-of-pocket for services provided by physicians, chiropractors, mental health providers, and other healthcare professionals. With the escalating costs of healthcare premiums, they want to ensure that the insurance company pays for their healthcare. To keep up with the current market, healthcare providers do not wish to exclude themselves from appealing to new patients—they must accept insurance. This means being enrolled in insurance plans or getting credentialed.

The Drawbacks of DIY Medical Credentialing

The difficulties of taking a DIY approach to credentialing can be numerous. When you undertake this time-consuming and tedious task, keep in mind some of the guidelines typically required for each insurance panel:

  • Decide about which insurance panels you want to be on.
  • Find time to make phone calls to identify the most updated insurance applications and fill them out.
  • Complete the detailed applications, each spanning from 30 to nearly 100 pages. Pay attention to specifics, as the applications require information in certain formats.
  • Follow up with each insurance company to confirm that the application was received. If applications are misplaced or lost, they are not reviewed. While applications sit in a pile, possibly for weeks, enough time may elapse to cause them to expire and be rejected. If that happens, the process must start from the beginning.
  • Send additional documentation to the insurance companies.
  • Spend more time on the phone with each insurance company to ensure that the materials were received and are being processed.
  • In many instances, more time is necessary for clarifications or additional information on the applications.
  • Follow up at least every two weeks to ensure the applications have not been lost or forgotten and are indeed being processed.
  • A formal appeal must be submitted in response if an application is rejected.

The Best Choice for Medical Credentialing

You can bypass the frustrations and time it takes for medical credentialing by choosing a top-notch team. When medical credentialing is left to the professionals at Credentialing.com, impeccable service and attention to detail make the process a breeze. The following are the benefits of choosing Credentialing.com:

  • The experts assist in selecting the insurance panels that are ideal for you.
  • You complete only one simple form—our Master Survey.
  • The credentialing team efficiently works on securing your insurance panels.
  • Tracking an application’s progress online is easy and available wherever you are and whenever you want—24 hours a day, seven days a week. In addition, your credentialing account is viewed in real time. You can also call the credentialing team anytime for an update on your medical credentialing progress.
  • Thousands of healthcare professionals have trusted the superior Credentialing.com team for medical credentialing and have benefited from outstanding results.
  • Medical credentialing through Credentialing.com is affordable.
  • Credentialing.com credentialing is the reputable choice for nurses, counselors, psychologists, chiropractors, and many other healthcare practitioners. While becoming credentialed with insurance providers is one of the most significant things you can do for the benefit of your practice and patients, it is also one of the most burdensome tasks of all. The team at Credentialing.com can help take the complications and hassles out of medical credentialing for you.