Credentialing Process – How to get on insurance panels with our help
To provide the most transparent, consistent, and efficient service to our clients, we’ve developed a simple 5-step credentialing (i.e., provider enrollment, getting in insurance panels) process.
Step 0.5: Introduction
Decide how many insurance companies or EAPs you’d like to work with. For more persons in private practice, we recommend 10, but you can revise that number anytime.
Step 1: Selection
Select the insurance companies or EAPs you want to be networked with.
- United Healthcare
- and many others to choose from.
If you’re not sure what panels you’re interested in, our support team can help you decide.
Complete master survey (our information gathering tool).
Send in necessary documentation (resume, degree info, etc).
Step 2: Application
We retrieve all up-to-date insurance applications and complete them on your behalf.
We create and/or update your CAQH profile as necessary
We report any “closed” panels to you, and per your request submit an appeal on your behalf.
Step 3: Follow Up
We first follow up to make sure all applications have are received
Then, we follow up regularly to ensure the enrollment process moves from the “credentialing and approval” phase to the “contracting” phase.
We navigate any issues that come up along the way
Step 4: Contracting
We receive contracts from insurance companies and EAPs, review them for accuracy, and send them to you to be approved and signed.
We will negotiate any rates or terms based on your feedback.
Step 5: Confirmation
We submit signed contracts on your behalf.
We track, and follow up as necessary, to ensure you receive written confirmation of your enrollment.
You’re now ready to see clients and bill their insurance or EAP!
At Credentialing.com, we use a high-caliber project management system to organize and track every client project. You have complete access to see all documents, as well as all correspondences including emails and telephone calls with insurance companies and EAPs. Want to know where you are in the credentialing process, you can view your progress and status first-hand!