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Is Medical Insurance Credentialing Necessary?

Medical Insurance Credentialing is required if you wish to bill insurance companies as a participating provider. As a physician or office manager of a medical practice you should be aware of what insurances you are contracted or credentialed with. Surprisingly, many medical professional do not know this information. Keeping an up-to-date matrix of the physicians and what insurances they have been contracted or credentialed with is essential. A CAQH (Council for Affordable Quality Healthcare) account makes managing this information relatively easy. The CAQH is a not-for-profit concerted alliance of the leading health plans and networks in the nation. Their database collects detailed information on each provider in their system. Data collected includes their personal information, level of education, work history, their speciality and other information required when completing and application for various insurances.

Common Medical Insurance Credentialing Mistakes

The most common mistake associated with credentialing is a lack of attention to the meticulous details. Common areas for mistakes could be incorrect legal business name, the format of the zip code or something as simple as the color of the ink used to sign original signatures. A denial can generated by something as simples as forgetting a comma in your legal business name. At WorkSmart MD our credentialing team knows how to manage the credentialing process and your applications are approved on the first submission. Our credentialing team carefully reviews each CAQH provider database to ensure all information has been updated to reflect the current practice. Also, all applications go through a rigorous review process to certify accuracy. When engaged in the credentialing process it’s imperative for the medical practice to offer complete cooperation and provide accurate and succinct information.

WorkSmart MD credentialing services are available to all medical practices. It doesn't matter if you have an individual practice, a group practice or even multiple locations we can take care of your credentialing needs. If you would like to learn more just call and talk to one of our credentialing experts.

For a no-obligation analysis Call us toll free at 877.242.8475