Medical Billing Credentialing Services

Importance of Insurance Credentialing

Credentialing and contracting form the foundation of starting a clinic or healthcare facility. They establish essential relationships with insurance companies and patients, enabling enrollment in insurance companies’ preferred provider networks. Med Billing’s credentialing services ensure your inclusion in these networks with contracts that benefit you, ultimately enhancing patient care, satisfaction, and revenue. Our goal is to help your facility serve a larger patient pool and improve patient satisfaction.

Why Choose Med Billing for Credentialing Services

Credentialing and contracting are vital to starting a healthcare practice, laying the groundwork for relationships with insurance companies and patients. Med Billing offers credentialing services to various hospitals and healthcare systems, securing and negotiating contracts with insurance payors. We manage the responsibility of keeping your facility or physician’s contracts with insurance carriers up-to-date.

Leverage our expertise to facilitate your relationships with insurance companies and patients, allowing you to serve more patients, improve service quality, and achieve the highest reimbursement rates.

According to Forbes, the largest insurance companies in the US by sales include:

1. Blue Cross Blue Shield
2. UnitedHealth Group
3. Anthem
4. Aetna
5. Cigna
6. Humana

Despite the limited number of major insurance companies, Med Billing navigates their systems effortlessly to deliver the results you need. Modern insurance companies cover a wide range of services, including mental and behavioral health, with fewer restrictions on pre-existing conditions, making it easier to meet patient needs.

With insurance companies often closing their panels and creating high entry barriers, Med Billing ensures these challenges are overcome.

Negotiating In-Network Contracts

Effective contract negotiation is crucial for growing your facility. Our aggressive negotiation tactics and long-standing relationships, spanning over twenty-five years, always benefit our clients. Poorly negotiated contracts can result in lost revenue, which is why this task should be handled by experts.

Our EDI team has built relationships with most network managers in insurance companies. Med Billing exploits certain conditions, such as patient volumes in specific localities, to secure the best rates for each physician.

We provide credentialing services to numerous individual providers and hospitals, enrolling physicians in both government and private insurance networks.

Building Long-Lasting Relationships Over 25 Years

Understanding the nuances of contracts is key to maximizing reimbursements and preventing denials, ensuring your revenue cycle operates smoothly. Proper contract management provides timely and accurate reimbursements. Med Billing handles all aspects of the contracting process, including defining and explaining provider reimbursements and arranging healthcare service delivery to patients. We also manage negotiations to secure the best rates.

Keeping up with various insurance companies is a daunting task in revenue cycle management. Ensuring your contracts offer the best rates is crucial for adequate compensation, allowing you to better care for your patients. This directly impacts your financial growth.

Being part of these networks significantly increases your patient pool, as patients prefer providers within their network due to high healthcare costs. This availability to more patients across your service area is beneficial.

However, low rates for patients in certain networks or plans can impact your revenue. Thus, effective negotiation during contract creation is essential, as higher out-of-pocket costs for services mean less investment in patient care. Patient care is your priority, and ensuring optimal revenue is ours.

Med Billing Can Help with Credentialing Services

Credentialing involves months of back-and-forth communication and documentation, making it a highly time-consuming process. Instead of hiring a company that only offers credentialing services, choose Med Billing for a comprehensive solution to all your financial needs. This is why Med Billing is recognized as a reputable medical billing and credentialing services provider across the US.