CureMD's comprehensive medical credentialing services enable healthcare providers to simplify the provider enrollment and credentialing process, avoid claim delays, and save time and resources. With our centralized process and knowledgeable experts, providers can recognize revenue sooner and free themselves from the hassle of handling piles of printed documents and tiring follow-ups.
Service Highlights
Contract Execution
Once the initial phase of physician credentialing completed, we ensure insurances offer and execute contracts to complete the enrollment process.
CAQH Enrollment
CAQH (Council for Affordable Quality Healthcare) application submission for providers to credential with individual payers.
Application Submissions
Once we have all the required documentation, we prepare and submit the required applications to the payer organizations.
Payer Communication
Manage payer communications, verifications, and follow-up activities and related tasks.
Data Gathering and Verification
Guiding provider and practice staff to gather the required demographics and background information. Verification of data for correction and document validity to ensure correct information is sent to insurances in the first go.
Hospital Privileges Application
Help in getting hospital privileges that are required by most insurance to process the provider credentialing application and offer a contract. We handle everything from application submission to the follow-up and application completion.
Provider Enrollment Services / Medical and Physician Credentialing Services
Eliminate all the headaches, tons of paperwork, and all the confusion associated with the insurance companies.
Let CureMD help you navigate the difficult process of provider enrollment and medical credentialing
all at lowest possible cost.
- Physicians
- PAs/ NPs
- Hospitals
- PT/OT/SLP
- Podiatrists (DPM)
- Chiropractors (DC)
- Ambulatory Surgery Centers (ASC)
- Urgent Care Facilities
- Clinical Laboratories
- Diagnostic Testing Facilities (IDTF)
- Sleep Labs
- Optometrists
- Audiologists
- Behavioral Health Providers
- Many More
What Enrollment and Physician Credentialing Services We Help With
Commercial Insurance Provider Enrollment and physician Credentialing (e.g: Aetna, Anthem, Oxford, BCBS, CIGNA, TriCare, Humana, UnitedHealthcare and More)
- Medicare and Medicaid Revalidation
- PECOS
- CAQH Registration
- NPI Registration (Type I and Type II)
- Reimbursement Issues
- Managed Care Contracting Issues
Benefits
- Save weeks and hundreds of hours of repetitive manual work, free your staff to do more valuable work, reduce risk and lost revenue.
- Eliminate unnecessary headache due to the mounds of paperwork, endless applications and insurance follow up.
- Increase patient referrals and volume.
- Get paid faster.
- Dedicated project manager and award-winning customer service.
- End to end service – from information gathering, submission, follow-ups, e-mails and faxes.
- 24x7 access to all your documents and updated status of your application.
Frequently Asked Questions
When will Credentialing services begin?
Your medical Credentialing services will initiate 3 business days of receiving the submitted proposal and credentialing information.
How long does it take?
It typically takes approx 120 days to fully credential a new provider. Some payers only take 30-60 days while others take 150 days. If you have group contract with insurances, the process of adding a new provider to the practice will be faster as new contracts are not required.
What are the benefits of CAQH and what is the application process?
An overview of CAQH includes the following benefits:
- Over 90% health insurances use CAQH as a prerequisite for provider enrollment.
- CAQH centralized database is considered an industry-wide standard system that supports a robust credentialing process.
- Instead of calling the provider office for work history or a copy of their medical license, insurances can pull it this information directly from your CAQH file.
CAQH Credentialing process:
- Obtain your CAQH ID - 2-3 business days
- Set up your secure username and password
- Complete the online application and send the required documentation
- Send signature attestation to certify your application
- Grant access to the insurance companies of your application
- You are now ready to start the credentialing/contracting process with the insurers
What documents are required for credentialing?
Individual provider documents:
- State Medical License
- Certificate of Malpractice Insurance (COI)
- Federal DEA License
- State DEA License (CDS License; if required by state)
- Board Certification(s)
- Current CV (use MM/YYYY format; show current employer)
- Driver's License
- Diploma (highest level of education)
- ECFMG Certificate (for providers educated outside the United States; Educational Commission for Foreign Medical Graduates)
- Collaborative Agreement (required for Nurse Practitioners only)
- Prescribing Arrangement Letter (for providers not holding federal DEA License)
- Admitting Arrangement Letter (for providers who do not have active hospital admitting privileges)
Legal entity documents (copies only for license and certificate requirements):
- State Business License
- Certificate of Malpractice Insurance (COI)
- CLIA Certificate (if applicable; Clinical Laboratory Improvement Amendments of 1988)
- IRS W-9 Form
- IRS Form CP575 or replacement letter 147C (verification of EIN/TIN)
- Bank Account Verification Letter or a copy of the voided check
Note: This is the standard listing of the documents that are usually required by the insurances for regular providers, groups, or facilities. Third-party insurances may require more or fewer documents, depends on the type of provider and services being offered, to complete the healthcare credentialing process.
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