Credentialing protects patients, prevents revenue loss and protects reputations
Credentialing is a vital process for all healthcare organizations that must be performed regularly to ensure that those healthcare workers who will be providing clinical services are qualified to do so.
If you visualize healthcare as a series of interlocking processes, the most profoundly important process is to trust that providers can do what they say they can do. Unfortunately, it’s a requirement that often results in healthcare providers not getting paid. Keeping up with the requirements is an onerous and time-consuming set of activities that benefits greatly from advanced software and experienced personnel.
EqualizeRCM relieves the administrative burden of credentialing – nationwide
EqualizeRCM has a highly focused Credentialing Group that is specifically designed to support the needs of hospitals, physician groups, urgent care centers, community health centers, behavioral health facilities, telehealth providers, vision providers, and more. This can be accomplished by working with EqualizeRCM and our partner 1st Credentialing, a highly regarded credentialing service and experts in their field.
- Primary Source Verification (PSV)
Proving that a provider is appropriately qualified requires a process called Primary Source Verification. It means you cannot take someone’s word for a provider’s qualifications, you must provide proof from a primary source that what the provider claims is true, is indeed true. This is a task that is exacting and can be tedious. That is where mistakes can be made, and in this field, mistakes are unacceptable. Mistakes endanger patients, put the practice at risk, and reduce revenues while they are corrected.
- Payor Enrollment
Payor enrollment entails applying for in-network status for medical professionals and facilities. This process is critical to ensure all medical professionals become billable as soon possible. Because EqualizeRCM has credentialing professionals on our team, we can quickly improve your revenue flow for both government and private insurers.
Using proprietary 1sCred software, we speed up the labor-intensive process of tracking renewals and completing applications while also providing comprehensive reporting on each credentialing detail of your practice and providers. Among the services we regularly perform:
- Multi-state contracting
- Delegated credentialing
- Sanction monitoring
- Project work for PSV and Payor Enrollment
- Monthly maintenance
- Application submissions for new clinics/providers
- CAQH attestations each quarter
- Retrieve fee schedules
- Add practice locations with insurance carriers
- Appeals of closed insurance panel
For efficient, reliable and affordable credentialing, ask us how we can help you by completing the form below and we will respond quickly.
The Credentialing Group at EqualizeRCM is specifically designed to support the needs of hospitals, physician groups, urgent care centers, community health centers, behavioral health facilities, telehealth providers, vision providers, and more.