Medical Audit
Medical Credentialing Services Get Credentialed & Enrolled
Mediclaimz is a leading Medical Credentialing Service Provider. Our Outsourced Credentialing Services reduce administrative burdens, unlock privileges, ensure in-network integration, and speed up reimbursements. We’ve helped doctors, nurses, and therapists advance in their careers. Join the many satisfied professionals with our Doctor Credentialing and Enrollment Services.
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Take the First Step to Better Health Today
Partner with MediClaimz for seamless claim processing, faster reimbursements, and optimized revenue cycle management.
MediClamz Consultancy Features
Why Choose MediClamz Billing Consultation?
1st Class Reimbursement
Enjoy the benefit of priority reimbursement rates, maximizing your financial returns. This ensures higher payments for the same services, boosting your profitability and satisfaction.
Maximum Privileges
Our streamlined approach not only wins you contracts but also secures vital privileges. You will be able to participate in innovative programs, as well as get incentives for quality performance.
Billing-Ready
You'll be ready to bill from day one, saving valuable time. You'll also receive a unique provider ID number (PIN) to submit claims electronically and track them online.
Swift Reimbursement
Faster reimbursements ensure a steady cash flow for your practice. With claims processed in 15 to 30 days on average, you won’t have to wait months for payments.
Payer Support
Our advocacy ensures insurance companies support you. We negotiate on your behalf, resolve issues, and make sure you receive fair and timely paymentss
Minimize Denials
With our expertise, denials become a thing of the past, boosting your efficiency. We verify eligibility, obtain authorizations, and submit accurate claims, reducing errors and rejections.
Appointment
Schedule Your Care with Our Certified Experts
Work Hours
Available Monday to Saturday for reliable medical billing support.
Credentialing Services
We Enroll Providers In Premium Payer Networks In Record Time!
Credentialing, also known as insurance or doctor credentialing, is the process of verifying a healthcare provider’s qualifications, skills, and legitimacy. It ensures the provider holds the necessary licenses, certifications, and education to deliver healthcare services to patients.
Only credentialed providers are eligible to receive payments from payers and comply with state and federal regulations. Medical credentialing authorizes physicians to practice at specific facilities and be included in insurance networks like CMS/Medicare, Medicaid, Aetna, Cigna, Humana, UnitedHealthcare, and Blue Cross Blue Shield.
As a provider, you want quick credentialing to start practicing and billing legally and ethically. However, credentialing is a complex process requiring detailed documentation and verification at various stages by the insurance network. A single mistake can lead to denials and wasted time and resources.
Mediclaimz offers top-tier healthcare credentialing services. Our experts manage everything for you, from primary source verification to enrollment in leading payer networks, all within minimal time and budget.
Audit Solutions
A Walkthrough of Our Specialist-Vetted Provider Credentialing Process
Inaccurate billing and coding can be costly for medical practices. Denied claims result in lost revenue, while backlogs cause cash flow issues. Errors lead to audits and penalties. Our billing and coding audit service identifies weaknesses in your workflows. After analyzing your people, processes, and technology, we provide targeted recommendations to ensure compliance and improve your revenue cycle.
Surveying the provider
Our credentialing process starts with a thorough survey conducted by our credentialing specialists. This includes detailed interviews with providers to collect vital information such as license numbers, educational history, demographics, and professional background.
Choosing the insurance company
Our medical credentialing services guide providers in strategically choosing insurance partners aligned with their practice goals and license type, while also finalizing insurance panels based on practice locations.
CAQH Enrollment and Management
Lead to claim denials, loss of revenue, overcharges, underpayments, patient dissatisfaction, and legal actions.
Ensure Fast Credentialing Approval
Although the typical timeline is 60-120 days, our provider credentialing experts take proactive steps to accelerate the process. Our team engages in weekly interactions with payers, advocating for the rapid processing and endorsement of your credentialing applications.
In-Network Enrollment
Upon completing credentialing, your application enters the contract phase. Here, an in-network contract may be offered, including fee schedules and eligible CPT billing codes. We handle closed panel challenges, advocating through appeals to secure your inclusion. With successful credentialing, direct billing becomes feasible, often with preferred reimbursement rates for in-network providers.
Winning you Hospital Privileges Application
As credentialing wraps up, our active involvement persists. We assist you in gaining all necessary hospital privileges: whether it’s admitting, courtesy, or surgical rights.
Ongoing Monitoring and Updates
Our continuous oversight ensures that your company’s credentials remain current and that you stay credentialed without interruption. Our experts diligently track your credentialing expirations and conduct comprehensive daily and weekly reviews to maintain your active status. You can rest easy knowing that your credentials are in good hands with us.
MediClamz Consultancy Features
We Optimize Your Medical Billing and Coding Processes
Physicians
Our credentialing service ensures physicians gain swift access to insurance networks, accelerating patient care. It's crucial for maintaining credibility and trust with patients and peers.
PAs/NPs
Credentialing via our service aids PAs/NPs in expanding their practice reach, ensuring they're authorized to deliver essential medical services independently.
Hospitals
Credentialing with us streamlines hospital operations, enabling efficient insurance claims processing and fostering collaboration among medical staff.
PT/OT/SLP
Our credentialing facilitates therapists' inclusion in insurance panels, enabling them to offer vital rehabilitation services while maintaining financial stability.
Podiatrists (DPM)
Credentialing through us empowers podiatrists to offer specialized foot care, securing their position as recognized experts in their field.
Chiropractors (DC)
Our credentialing service solidifies chiropractors' standing in the medical community, granting them access to insurance networks for widespread patient engagement.
Ambulatory Surgery Centers (ASC)
Credentialing via our service for ASCs enhances patient trust by demonstrating adherence to rigorous quality standards, crucial for safe surgical procedures.
Urgent Care Facilities
Our credentialing ensures urgent care facilities are in-network with insurers, making prompt and affordable medical services accessible to a broader range of patients.
Diagnostic Testing Facilities
Credentialing helps diagnostic facilities and clinical laboratories gain insurance approval, increasing patient referrals and enabling prompt diagnosis and treatment.
Optometrists, Audiologists
Credentialing broadens the reach of optometrists and audiologists, allowing them to deliver essential eye & ear care services to a more diverse clientele.
Behavioral Health Providers
Our credentialing service aids behavioral health providers in becoming part of insurance networks, enabling vital mental health services to reach those in need.
Providers
Performed
Start Your Journey to Stress-Free Medical Billing!
Partner with MediClaimz for seamless claim processing, faster reimbursements, and optimized revenue cycle management.