Credentialing is the process of review and verification of the information of a health care provider who is interested in participating with Various Insurances in their County.
BCG Credentialing Services are expert leaders in Medical Credentialing, provider applications, enrollment forms, verification services, and other medical credential services
BCG provider application service processes and files documents for CMS Enrollments, Health Plan Paneling and State Applications etc. by using 855A, 855B, 855R, 8551 and 855S along with other standardized forms to help new and existing individual providers, practitioners, allied professionals, medical groups, surgical centers and clinics to increase their productivity and profitability.
The process begins with requesting Credentialing Application Kits from all the commercial and government health Insurances. After submitting the signed applications we follow-up with the payers to retrieve the Provider or Group ID # confirming that the doctor is participating with the insurance. We also give bi-weekly status updates to the provider until an effective date of enrollment is determined so the provider can begin claim submission.
Medical credentialing services are a vital component in the healthcare industry, ensuring that healthcare providers meet specific standards and qualifications to deliver care to patients. At Crest Pointe Billing, we offer comprehensive medical credentialing services designed to streamline the credentialing process, reduce administrative burdens, and improve overall efficiency.
VeriCre™ is our advanced credentialing solution that offers thorough verification of healthcare providers' credentials. It ensures that all necessary documentation is accurate and up-to-date, facilitating faster approval and reducing the likelihood of errors.
We create detailed initial profiles for healthcare providers, including all necessary credentials, certifications, and qualifications. This profile serves as the foundation for all subsequent credentialing activities.
Our reappointment profiles ensure that healthcare providers maintain their credentials over time. We track and manage renewal dates, required continuing education, and other criteria to ensure compliance with regulatory standards.
We offer specialized credentialing services for physician assistants (PAs), ensuring that they meet the specific requirements set by healthcare facilities and insurance providers.
Our continuous monitoring services provide ongoing verification of credentials, alerting healthcare providers to any changes or issues that may affect their ability to practice. This proactive approach helps maintain compliance and prevent potential disruptions.
We integrate data from the American Medical Association (AMA) to ensure that healthcare providers' profiles are comprehensive and up-to-date. This integration includes verification of licensure, board certifications, and other critical credentials.
Our services include access to AMA Physician Professional Data™, providing detailed information on healthcare providers' qualifications, training, and practice history.
We provide healthcare providers with access to their profiles, allowing them to review and update their credentials as needed. This transparency ensures that all information is accurate and current.
We offer a range of educational resources to help healthcare providers understand the credentialing process and maintain their credentials. These resources include guides, webinars, and other educational materials.
We assist healthcare providers in enrolling with commercial insurance plans, ensuring that they can accept a wide range of insurance policies and increase patient referrals.
Our services include enrollment with Medicare and Medicaid, allowing healthcare providers to serve a broader patient base and improve their revenue streams.
We manage the registration process for National Provider Identifiers (NPI), ensuring that healthcare providers meet this essential requirement for billing and insurance purposes.
We handle registration with the Council for Affordable Quality Healthcare (CAQH), streamlining the credentialing process and ensuring compliance with industry standards.
We assist healthcare providers with enrollment in Medicare's Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) program, expanding their service offerings.
Our team helps healthcare providers obtain and maintain hospital privileges, ensuring they can practice in various healthcare facilities and provide comprehensive care to their patients.
We offer contract negotiation services to ensure that healthcare providers receive fair and competitive reimbursement rates from insurance companies and healthcare facilities.
We manage the revalidation and re-credentialing process, ensuring that healthcare providers maintain their credentials and comply with regulatory requirements over time.
Our audit services identify and resolve reimbursement issues, ensuring that healthcare providers receive accurate and timely payments for their services.
We assist healthcare providers in obtaining and maintaining state licenses, ensuring compliance with state-specific regulations and standards.
Our services include obtaining and renewing DEA certificates, allowing healthcare providers to prescribe controlled substances legally and safely.
We handle the Clinical Laboratory Improvement Amendments (CLIA) registration process, enabling healthcare providers to conduct laboratory testing in compliance with federal regulations.
Save Time and Resources
Our credentialing services save healthcare providers time and resources by handling all aspects of the credentialing process, allowing them to focus on patient care.
Increase Patient Referrals
Credentialing with multiple insurance plans increases patient referrals, as more patients can access care through their insurance providers.
Get Paid Faster
Efficient credentialing ensures that healthcare providers can start billing and receiving payments more quickly, improving cash flow and financial stability.
Comprehensive Support
We offer comprehensive support throughout the credentialing process, providing healthcare providers with the guidance and assistance they need to succeed.
24/7 Document Access
Our online portal provides healthcare providers with 24/7 access to their credentialing documents, ensuring that they can review and update their information at any time.
Dedicated Project Manager
Each healthcare provider is assigned a dedicated project manager who oversees the credentialing process, ensuring timely and accurate completion.
Medical credentialing services verify that healthcare providers meet specific qualifications and standards, allowing them to deliver care and receive reimbursement from insurance companies.
VeriCre™ is our advanced credentialing solution that offers thorough verification of healthcare providers' credentials, ensuring all documentation is accurate and up-to-date.
We track and manage renewal dates and continuing education requirements to maintain compliance and ensure providers' credentials remain current.
Our continuous monitoring services provide ongoing verification of credentials, alerting providers to any changes or issues that may affect their ability to practice.
Integrating AMA data ensures that provider profiles are comprehensive and current, including verification of licensure and board certifications.
We ensure PAs meet specific requirements set by healthcare facilities and insurance providers, including necessary credentials and certifications.
Credentialing with multiple insurance plans makes it easier for patients to access care, increasing the likelihood of referrals.
We offer services for physicians, PAs, NPs, hospitals, therapists, podiatrists, chiropractors, labs, optometrists, audiologists, behavioral health providers, and more.