SERVICES
Credentialing
Strengthen Your Payer Network, Expand Your Horizons!
At AccuBilling, revenue is mission critical and we go above and beyond to help you fetch every dime. Our business framework is designed to streamline administrative and clinical operations, ensuring maximum returns at Industry’s lowest cost. It doesn’t just end there, we empower you to make data-driven decisions that significantly help you improve profits and patient engagement.
Get the In-Network Assurance with AccuBilling:
Better Financial Outcomes
At AccuBilling, we take pride in ensuring that your credentials are not just compliant but stand out for their efficiency and accuracy. Here’s why you should opt for us…
End-to-end Credentialing Solutions
Our comprehensive services include application preparation, document collection, ongoing monitoring and maintenance. We leverage the power of our expertise combined with cutting-edge technology to deliver streamlined and dependable credentialing solutions tailored to diverse practice needs.
Personalized Approach
Our dedicated, region-specific experts stay current with state requirements, advocating for you, negotiating on your behalf, and diligently pursuing your earnings. These are committed individuals who genuinely care, they’re readily accessible to answer questions, resolve issues, and offer support whenever you need it.
Maximized Healthcare Privileges
With our meticulous approach to credentialing, we ensure that your practice meets every criterion that helps you build a solid reputation and secure better privileges.
Better Financial Outcomes
Our streamlined workflows ensure continuous compliance, thereby making you eligible for first preference reimbursements, reduced processing time, minimized rejections and improved profitability.
Minimized Risk, Maximized Revenue
Say goodbye to insurance follow-up hassles and reduce the chances of lost revenue. With our expert credentialing services, you’ll always stay ahead of the curve.
Patient Growth Unlocked
Credentialing serves as a pivotal tool for broadening the patient base by facilitating access to insured individuals, fostering referrals, bolstering reputation, and capitalizing on marketing avenues offered by insurance companies and healthcare networks.Setting Standards, Securing Confidence
Your Trusted Credentialing Partner
Credentialing specialists at AccuBilling help you cut through the red tape and manage the hassle of endless paperwork, follow ups and regulations with our end-to-end medical credentialing services:
Payer Network Enrollment:
We optimize your in-network payer mix depending on your practice goals and location, securing a great combination of the most preferred and efficient providers.
Leveraging our extensive experience with Medicare, Medicaid, and Private Payers (United, Anthem, Aetna, CIGNA, Humana, BCBS, TriCare, United Healthcare and more) across the country, we proactively liaise with each selected payer to determine precise timelines and panel availability.
Application Filing and Follow-ups:
Our Enrollment team swiftly initiates the filing process after we procure the required documents and information from your end, ensuring flawless submissions right from the outset. We diligently follow up on your applications to make sure no additional information is needed, maintaining a seamless process throughout.
With our wealth of experience and a track record of first-time accurate submissions, our clients benefit from expedited contract processing, resulting in minimal turnaround times.
Appeals for Inclusion in Closed Panels:
In situations where some players like BCBS, Aetna, and UHC maintain closed panels for specific regions, we diligently submit comprehensive appeals showcasing your ability to provide exceptional patient care within that area. While overturning a closed panel decision is challenging, it is certainly worthwhile to pursue.
Out- of -Network Enrollments:
For providers who are compelled to operate Out-of-Network due to closed panels or opt to remain Out-of-Network with certain payers, our team assists with Out-Of-Network enrollments and NPI registrations directly on the payer’s website.
This ensures that the medical practice is seamlessly integrated into the payer’s system, enabling them to receive out-of-network payments promptly.
NPI Registration (Type I and Type II):
We help both individual providers (Type I) and organizations (Type II) to secure their NPI, a unique ten-digit ID number that helps insurers identify U.S. healthcare providers and organizations.
In addition to the Center for Medicare and Medicaid Services (CMS), all health insurers and healthcare clearinghouses use NPI numbers to process claims. Filing successful claims or billing insurance is contingent upon having an NPI.
CAQH Registration and Maintenance:
We specialize in registering your CAQH (Council for Affordable Quality Healthcare) profiles, an absolute necessity in today’s healthcare landscape. We even take care of the ongoing maintenance, including re-attestation and document submissions, to streamline your credentialing process.
CAQH profiles serve as a centralized repository for credentialing information, facilitating seamless access for health plans and related entities.
Re-Credentialing:
In the hustle and bustle of daily operations, re-credentialing every year or two often slips through the cracks. AccuBilling ensures it is done accurately, on time, every time! With our re-credentialing services, we assist providers in verifying their ongoing competence, preserving eligibility, and preventing disruptions and penalties.
Negotiating contracts:
We negotiate with insurance providers to ensure fair reimbursement rates, secure your inclusion in their networks, establish quality standards, and define policies, procedures and dispute resolution, all aimed at protecting the financial health of your practice. Proficient negotiation is pivotal in upholding a viable healthcare practice.
Privileging:
We help physicians in obtaining and renewing their hospital privileges, granting them the authority to practice at and admit patients to such hospitals.
Privileging enables physicians to treat patients, utilize hospital resources, and collaborate with fellow healthcare professionals. It also serves as a means for them to showcase their competency and expertise, leading to expanded horizons and recognition.
DMEPOS Coverage:
Through the DMEPOS Program, Medicare beneficiaries can access important resources such as braces, wheelchairs, surgical dressings, therapeutic shoes, oxygen equipment, and diabetic supplies.
Enrolling in this program not only elevates the standard of care delivered by healthcare providers but also guarantees reimbursement from Medicare.
Licensing, Certification and Registration:
We handle all your paperwork and approvals for licensing, certification, and registration, so that you can focus on what you do best, patient care!
We support healthcare providers in securing and maintaining their state medical licenses in the US, affirming their expertise and credentials while safeguarding them against professional liabilities.
Additionally, we meticulously verify all professional licenses, such as state and DEA credentials, ensuring that providers can deliver top-tier medical care as trusted professionals.
We facilitate CLIA registrations, essential for laboratories conducting diagnostic, preventive, or treatment-related tests.
Over 10k Applications Filed and Contracts Received
12 years of Provider/ Hospital Credentialing Experience
Credentialing effectively handled in all 50 States
Our Payer Network
We do all the work to get you connected to the most varied, popular and effective insurance providers, including but not limited to:
Advance Claim Review System: Unearthing Missed Revenue Opportunities
Rejected claims can be indicative of a process breakdown disguised as missed opportunities. At AccuBilling, we employ an outcome-driven approach to address and settle these claims:
Identifying the underlying cause of every single rejected claim and not just the “low-hanging fruits” or high value ones
We categorize unpaid claims, assigning high priority to the aging ones so that reappeal expirations are avoided. Every claim is allotted to specialists who take corrective measures in the allocated order.
Submitting a persuasive and professional reappeal addressing specific reasons of denial and including additional supporting document to present a stronger case.
Tracking the progress of every appeal with additional follow-ups in case no consensus is reached within the stipulated time frame. This ensures that no opportunity to overturn denials is missed.
We use an integrated approach to streamline denial management with other functions such as electronic health record (EHR) system, billing, coding, etc. This helps us further reduce the scope of errors in claim submission.
Comprehensive data and reporting allow us to use predictive analytics in anticipating potential denials before they can even happen. This prevents future revenue leakage and results in continuous process improvement.
Documenting the topmost denial causes and best practices to resolve them. Paying great attention to detail and assigning higher accountability to clean claim submission, leading to a higher first pass yield and better revenue inflow in the future.