In the healthcare industry, both physicians and providers must maintain their credentials with insurance authorities and federal bodies. This ensures complete participation and guarantees the full availability of benefits provided by the insurance carrier. However, the entire process of getting credentialed and updating the credentials can be very time-consuming and involves many hassles. Yet it needs to be completed on time and accurately to avert denied participation, loss in revenue, and patient dissatisfaction.
We at Flatworld Solutions have over 19 years of experience in assisting providers and medical professionals get credentialed with carriers on time. Over the years we have established relationships with the major health care carriers and so understand their enrollment process inside out and complete the credentialing in a guaranteed time. Also, we have complete knowledge of how to use the Council of Affordable Quality Healthcare (CAQH) and other online credentialing programs to assist you with the maintenance of your enrollment information.
Our Insurance Credentialing Services
We are a leading provider of insurance credentialing services and offer the following services to our clients -
ABA therapists can become accredited therapists only after they meet all their credentialing requirements in their field of practice. The ABA credentialing process is a tricky one; however, our detailed understanding of the process makes it simple and time-bound. We complete the whole process in around 90 to 120 days. We assist you in the two stages of the credentialing process i.e. applying for National Provider Identifier, assisting in becoming a member of The Council for Affordable Healthcare.
Aetna credentialing helps a provider become a part of the Aetna network, thereby ensuring that patients with the Aetna plan flock to use their particular medical service. Our services hand hold you through the entire process of applying to get into any insurance provider's network. Our process begins with obtaining a National Provider Identifier, submitting a request for participation before the application filing process, assisting with the CAQH registration process, authorizing Aetna to gain access to the enrollment application, and submitting all supporting documents to CAQH.
Mental Health Credentialing
Similar to other practitioners, mental health specialists, must also go through a complete credentialing process to legalize their practice. Our extensive services include getting your information in order (Licensure Information, NPI Number, Proof of Malpractice Insurance, etc.), filling out CAQH, contact provider relations, submit applications, and review the contract after approval. We have assisted several mental health practitioners and providers to get credentialed at a lesser cost and within a short turnaround time.
Cigna has a vast network of people subscribing to their health plans. As a part of the network, a medical service provider can cater to the health requirements of these large sections of the population. We make it easy for providers to procure Cigna credentialing. We assist you with the pre-application process, which entails meeting some general guidelines of insurance credentialing with Cigna, submitting the application, following-up throughout the credentialing process, and finally reviewing the Cigna approval.
Blue Cross Shield Association Credentialing
Our credentialing experts also have wide experience in Blue Cross Blue Shield Association credentialing and hence can work on your behalf through the entire process, thereby ensuring you meet your core areas of medical practice operations without having to undergo the hassle of the rigorous process. Our primary services for Blue Shield Association credentialing entails getting Credentialed or Re- Credentialed by submitting a resume and work history, obtaining an NPI, registering the NPI through an application process, registering with the carrier to be able to access Explanation of Payments (EOP), and signing an EFT to receive claims payment.
Getting credentialed with the CAQH is important because it helps a practitioner or a provider get enlisted with a single source to submit their information. If an insurance company uses CAQH as its database, then it advisable for the provider to have this credentialing to avail of the services of the insurance company. Those bereft of a CAQH application need to apply separately to multiple insurance companies, making reimbursement a cumbersome and time-consuming process. Our service entails getting a CAQH number, keeping basic information ready, and completing the CAQH profile.
Humana Health Insurance Credentialing
Humana Inc is a well-known health care program with over 13 million Americans under its coverage. The company credentials all licensed practitioners including physicians, non-physicians providers, and clinics that meet its requirements. We take you through the tedious process of pre-application where a representative is assigned to ensure the practitioner or facility meets all the mandatory guidelines, submitting the application after the practitioner is approved by the representative, following up, and finally reviewing the Humana approval.
Oscar Insurance Credentialing
The Oscar insurance company is a technology-focused company that banks on advanced technology to engage with clients. The company specializes in telemedicine, healthcare interfaces, and transparent claims pricing systems. The company has over 25,000 members covered under its program which includes 3500 nationally ranked doctors, as well as 20 renowned health systems in the US. We have vast experience in assisting our clients get covered under the Oscar insurance program, taking care of all the stages such as pre-application, application submission, being in touch till the approval is confirmed, and then reviewing the terms and conditions of the approval.
Bankers Life Insurance Credentialing
Bankers Life insurance credentialing, a subsidiary of the CNO financial group, has over 1.4 million policyholders and offers a range of insurance products such as term care, life insurance, annuities, critical illness insurance, Medicare advantage plans, Medicare products including supplement lines, etc. Besides this, the company has entered into a partnership with Humana to provide dental and vision plans to their clients. Our credentialing assistance services for Bankers Life Insurance includes assisting you in getting information in order, filling out CAQH, submitting an application, and application review.
Addiction Treatment Credentialing
Addiction Treatment Credentialing is required for medical practices that deal with the treatment of substance abuse disorder. The US today has an addiction workforce consisting of counselors, educators, and healthcare professionals, all totaling nearly 100,000. Our services are designed to assist addiction healthcare professionals to procure the necessary license requirements to serve new patients and get paid for the services they perform. We primarily help our clients apply for the National Provider Identifier and become a member of The Council for Affordable Healthcare. Our experience in assisting numerous practitioners and practices get credentialed for addiction treatment will help you remove the hassle involved in the process.
Insurance Credentialing Process for UMR
UMR is the largest third-party administrator in the US and serves a range of healthcare management plans, including claims processing for self-funded vision, dental, and disability plans. Besides it also offers a wide variety of ancillary services such as reinsurance products, claims recovery management, claim re-pricing, and provider data management services and products. We help you in the end-to-end process of UMR credentialing which includes pre-application, application submission, application follow-up, and review of united healthcare approval.
Other Credentialing Services
We specialize in offering other ancillary services related to credentialing such as -
- Credentialing Doctors to Your Group Practice - The process of credentialing doctors to your group practice involves lots of paperwork and constant follow-ups, all of which make it a very time-consuming and costly affair. Our clients leverage our experience to avoid all associated hassles. Besides we assist practices to understand which insurance companies to panel with, whether or not to set up a group contract with an insurance company, and so on.
- Insurance Credentialing 101 - With this service, we give you a clear understanding of the dos and don'ts for credentialing. Given that practitioners have other objectives before them, going through this requirement of credentialing can be very daunting and overwhelming. Our services entail enlightening you on the requirements as well as simplifying the concept as much as we can by focusing on the most vital aspects. Our initiation process includes helping you arrange and understand the vast array of different information sets that need to be submitted.
- Letter of Interest for Insurance Credentialing - This service is related to sending a letter of interest to an insurance company to get paneled with them. The preparation of this letter requires some critical information that matches the enrollment application. Besides, it is important to mention the unique attributes associated with your practice, geographic location, patient demographics, referring services, trial programs of your service, and rates.
- Top Insurance Companies to Be Credentialed With - Independent practitioners and practices need to have an idea of the top insurance credentialing companies in terms of company revenue, company goodwill, lives covered, accessibility, etc. We assist them to identify the top insurance companies that would best fit their services as per the top considerations. As insurance credentialing experts, we assist our clients to crack the overwhelming process of credentialing.
- Insurance Credentialing for Nurse Practitioners - Credentialing for nurse practitioners is as important as it is for other practitioners in the field. However, the requirements and process of credentialing are quite different for them. Given that the associated challenges are different and can cause a lot of hassle, we take up the cudgels on behalf of the practice to make nurse credentialing easy and time-bound.
Our Insurance Credentialing Process
We have a well-defined and checklist-based process to get practitioners and practices credentialed. The steps include -
01. Understanding the Practice and Contacting the Insurance Carrier
We sit with you to assess your practice and its requirements. While we have complete knowledge of all carrier requirements yet, as a first step, we initiate communication with the provider services department to confirm their credentialing process and obtain a credentialing application.
02. Filling Provider Application
After procuring the application, our experts take time to fully complete the application. While filling applications, we list all service locations for your practice, including copies of all required documents, and sign and date your application.
03. Update Your CAQH Application
We get you credentialed with the CAQH. In case you are already credentialed, we ensure that your CAQH profile is up to date with all information such as location information and includes necessary documents such as license, board certifications, etc.
04. Follow-up with the Insurance Company
After applying, we verify with the insurance company to confirm whether your credentialing application was received. This is followed by regular follow-up with the insurance network till the process is completed and you have a network effective date with a participating provider agreement.
05. Provide Other Information and Document
Insurance companies may need some additional information on a practice to practice basis. We keep ourselves in standby mode to respond to any requests for additional information that the insurance company may want. During the entire process, we document all the follow-up activities.
06. Review Contract
After getting the approval, we review your participating provider contract. We scan for all important details such as the claims submission procedures, fee schedule for your services, deadline for filing limits, etc. After the review, we handover all the copies of credentialing applications and contracts to you.
07. Expiring Documents Alerts
Our credentialing services include monitoring and tracking credential renewal dates and alerting you of the same. Our monitoring services combined with our centralized file systems help us have a clear overview of every doctor and every document that is about to expire. It also serves as a checklist for collecting documents. We send emails notifying practitioners and practices about any imminent document expiry dates.
Insurance Software we use
Other Services You Can Benefit From
Benefits of Outsourcing Insurance Credential Services to Flatworld Solutions
As a renowned insurance credentialing service provider we offer a range of benefits to our clients. These include -
We offer our clients services at prices below our closest competitors and other staffing agencies. Besides, we offer maximum freedom and flexibility. Our competitive rate supports medical professionals and covers end-to-end credentialing services starting from gathering, auditing, and uploading all necessary documentation such as resumes, licenses, immunity records, and certifications and diplomas.
We provide a high-quality, agile workforce with robust knowledge of verifying medical records like drug screens, background checks, etc. All our experts have extensive experience in obtaining all required documents and missing information for the credentialing process, undertaking site visits, following policies and procedures for credentialing, and maintenance of provider manuals and provider tools, etc.
Proactive Credentialing Services
Most insurers depend on CAQH for their credentialing process. We assist you to create, update, and keep your CAQH up to date. We back our services with a status tracking dashboard to enhance process transparency and provide the necessary drive to speed up the credentialing application status.
Compliance and 24/7 Services
We offer round the clock services as we operate from multiple global delivery centers. Also, we are 100% compliant with the Affordable Care Act, Medicare, HIPAA, and Medicaid. We also stay current on municipal, state, and federal guidelines, and fine-tune our processes accordingly to keep your records straight and well organized. We also help save on time by obviating the need to submit the same information for the same physician multiple times.
Client Success Stories
Flatworld Solutions Provided Insurance Services for US-based Insurance Agency
Flatworld Solutions provided support to manage an insurance database to a US client. Additionally, we assisted in the management of insurance accounts and AR functions.
Flatworld Solutions Provided Policy Checking Services for a US-based Insurance Service Provider
Flatworld Solutions helped in speeding up the process for a US client with policy checking services. The services were provided at cost-effective rates in quick TAT.
Outsource Insurance Credentialing Services to Flatworld Solutions
Working with Flatworld Solutions has been a delight right from the start. They are highly reliable and professional.Chief Operating Officer,
Insurance Marketing Company, Florida More Testimonials »
Flatworld Solutions has over 19 years of experience in providing insurance credentialing services to global clients, including US-based practices and practitioners. Our specialized services take care of every aspect of health care providers' insurance enrollment and credentials management. We bank on a highly streamlined provider insurance enrollment and credentials management process to make sure credentialing is completed on time and at cost-effective rates. Over the years, we have empowered our clients to focus more on efficient patient care and deliver quality services without having to worry about credentialing requirements.
If you are looking for the best insurance credentialing services providing company, get in touch with our experts now.