Credentialing

Credentialing

Each Insurance Carrier you apply for typically requires dozens of pages of paperwork, and lengthy online applications.

We act as an extension of your practice to complete all the paperwork and diligently follow up to get you credentialed with as many payers as possible.

How important is it for your practice to be ‘in network’?

As your front office can probably attest most potential new patients will first ask if you are participating with their insurance. If you are not in their network, then odds are they will not make an appointment with your office.

Also, since the health plans cover more pre-existing conditions, expanded mental health services, etc. being an approved provider is more beneficial to the bottom line of your practice.

EMS AZ PLLC Credentialing Services Include:

Full Service Credentialing

Completion of credentialing applications for insurance carriers and hospitals.

We will also do all necessary follow up with insurance carriers and track the application through to the approval stage.

Maintain Credentialing Documentation

We maintain all pertinent credentialing documentation (e.g. DEA, CDS, Medical Licenses, Board Certificates, Malpractice Insurance Face Sheets, CME’s etc.

Distribution of Renewed Documentation

We distribute all renewed documents including DEA, CDS, Malpractice Insurance Face Sheets, Medical Licenses, updated CME’s etc., to insurance carriers and the hospitals.

Document Tracking

We track and provide advanced notification of expiring licenses, DEA, CDS, etc.

We function as the liaison between the practice and the insurance carriers and hospitals with all matters relating to the credentialing/re-credentialing process.

Insurance Matrix

We will provide your office with an insurance matrix, which lists the individual physician, each insurance carrier and the physician’s status with the plan, Personal Identification Number and effective date with the insurance plan. The matrix will be updated each time there is a change in status

Completion of CAQH Proview Profile

  • Register providers and groups with the NPPES to obtain an NPI number
  • Enroll for Electronic Funds Transfer (EFT)
  • Enroll for Electronic Remittance Advice (ERA)

Let EMS AZ Medical Billing and Credentialing Services take on the behind the scenes work of your practice, so you and your staff can devote your attention to the care of your patients. We promise you won’t miss waiting on hold for hours with an insurance company trying to follow up on all those unpaid claims.

Why should we choose EMS AZ PLLC Medical Billing and Credentialing Services Instead of another billing company?

We have many years of experience and training in the Medical Billing and Practice Management area and will ensure that your practice is more profitable than ever before. The contacts that we have developed over the years have proven to be invaluable in “getting the job done”.

Credentialing fees are charged on a “per” application fee for each insurance carrier, for each provider. We monitor the process of the application through the final stages.

Can you only contract with practices in your area?

No, with today’s technology any practice in the country can enjoy the services of our company. If using your own EMR program, we can work from electronic superbills through EMR integration.