Credentialing Services
Patients hate hearing the phrase, “Sorry, we can’t treat you.” Don’t lose your Medicare and other private insurer patients because you’re not credentialed with them. Let us help you get enrolled with different payers to maximize your revenue.
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Outsource Credentialing Services
Let us provide you with solid reasons why you should outsource your credentialing services to MAS RCM and what makes us different.
- Save your time and resources for core tasks. Let us handle the lengthy credentialing procedures and reduce paperwork, allowing you to focus on patient care.
- We are a HIPAA-compliant medical billing company serving both NPI Type 1 and NPI Type 2 providers to minimize errors and reduce penalty risks.
- Our Credentialers are professionals who know what they do and do it quickly and easily, allowing the providers to follow the process alongside them.
- Outsourcing is beneficial for the practice as it reduces in-house credentialing costs, lowers salaries, and cuts training expenses.
- Adjacent to handling multiple providers/practices efficiently, delivering on time, and ensuring managed documentation.
Stop Losing Patients & Accelerate Your Revenue
5% to 10% of annual revenue is lost by healthcare practices due to delays and denials in credentialing services. MAS RCM has over 5 years of experience in credentialing services. Let us handle it for you to speed up incoming revenue and improve patient satisfaction.
Credentialing Procedure MAS RCM Follows
Verify Provider Information
Gather and verify the provider’s personal and professional information, including medical licenses, education, certifications, malpractice insurance, and work history. Ensure all details are accurate and up-to-date.
Complete Credentialing Application
After verifying the provider information ourselves, we complete the credentialing applications for various insurance companies, health plans, and networks. We also include all required documents, such as malpractice insurance, background checks, and tax identification numbers.
Submit Application and Documentation
Submit the completed application and supporting documents to the relevant payers. Ensure all forms are signed and the documents are complete to prevent delays.
Monitor and Follow Up
Regularly monitor the credentialing process with each payer and follow up with insurance companies and networks to ensure timely processing, addressing any issues or missing documents promptly.
Credentialing Approval & Denials
Once credentialing is completed, the insurance will either approve or deny the provider’s application. We communicate the results to the provider and assist in resolving any issues that arise from denials.
Updates and Re-credentialing
MAS RCM regularly maintains and updates providers’ credentials. We track re-credentialing dates and follow up with insurers to ensure timely re-credentialing, preventing disruptions in payments or patient care.
We Credential For
Government Insurances Medicare & Medicaid
We provide end-to-end medical credentialing services for government insurance plans, ensuring providers are eligible to treat beneficiaries.
Commercial Insurances
Get credentialed with multiple private insurers like Humana, Aetna, and Cigna through our services, ensuring timely and faster payments that help grow providers and their practices.
We Take Care of all Licensing and Certifications
Credentialing is a time-consuming process that can take anywhere from 30 days to a maximum of 6 months. Facing a denial during credentialing can be incredibly frustrating. Save your time with MAS RCM. We ensure that every document required by the payer is available and verified, making the process faster including.
- HIPAA Certification: Compliance with HIPAA standards to protect patient data.
- State Licensing: Management of state licenses for legal operation.
- DEA Certification: Certification for handling controlled substances.
- CLIA Registration: Ensuring your lab meets federal testing standards.
- Nursing Licenses: Verifying that nursing staff hold valid, current licenses.
CAQH Maintenance & Registration
MAS RCM manages the Council for Affordable Quality Healthcare (CAQH) profile, which is crucial for every provider as it helps minimize the credentialing efforts required when applying for different insurances repeatedly. It is kept updated and compliant with industry standards.
Credentialing Expert For Personalized Support
Every specialty is unique and serves its own needs. MAS RCM experts are always available to address credentialing, billing, and any other queries providers may have regarding our services. Additionally, we offer patient help desk services to help practices grow, improve the patient experience, and enhance healthcare services.
Specialty Focused Credentialing Services
Every payer has its own policies regarding physician credentialing services. We help providers navigate these challenges according to the unique needs of their specialty.
Healthcare Facilities We Credential For:
Hospitals
Clinics
Long-Term Care Facilities
Ambulatory Surgical Centers (ASCs)
Home Healthcare Providers
Diagnostic and Imaging Centers
Pharmacies
Rehabilitation Facilities
Mental Health Facilities
Dialysis Centers
FAQ’s
What is the credentialing process and how long does it take?
Credentialing involves verifying a provider’s qualifications and submitting applications to insurers. It can take anywhere from 30 days to six months, depending on the insurer and the completeness of the documentation.
Why is it important to stay credentialed with insurance companies?
Staying credentialed ensures you are eligible for reimbursements from insurers, preventing disruptions in patient care and revenue flow. Expired or missing credentials can result in claim denials and loss of patients.
How do I handle credentialing denials?
If your credentialing is denied, we assist with identifying the cause and provide guidance on how to resolve the issue, ensuring all documentation is complete and accurate to reapply.
What are the costs of outsourcing credentialing services?
Outsourcing credentialing services can reduce in-house costs, including salaries and training. It also prevents costly delays and errors that can impact revenue and patient care.
Can you help me with credentialing for multiple insurance companies?
Yes, we handle credentialing with various commercial and government insurers, ensuring timely submissions and follow-ups to maximize your revenue and practice growth.