Medical Credentialing and Insurance Credentialing Services

Our Services Include

  • Individual Provider Enrollment / Medical Credentialing
  • Group Provider Enrollment
  • Primary Source Verification
  • Hospital Privileging / Medical Staff credentialing
  • Recredentialing
  • Credentialing Appeals
  • CAQH Completion and Management

Provider Credentialing

Physicians that want their medical credentialing completed accurately and quickly without having to bear the strain of doing it themselves turn to the staff, who has over ten years of experience.

Nurse Credentialing

By selecting an excellent team, you may avoid the disappointments and time involved in the medical credentialing process. Medical credentialing is made easy when you entrust the process to our company’s experts because of their flawless service and meticulous attention to detail.


Recredentialing can be a challenging and time-consuming procedure. Not all insurance providers notify you when you need to re-enroll in order to stay in network. Even while the re-enrollment paperwork isn't as complicated as the original credentialing forms, it can still be harmful to your ability to continue billing the insurance company if you skip a step or don't finish a requirement on time. That's where Credentialing's Recredentialing Management comes in useful!

Services Are Provided to the

who can benefits from us

  • Physicians
  • Dentist
  • Psychologist
  • Hospital Privileging / Medical Staff credentialing
  • Facilities/Large Medical Centers
  • Healthcare Facilities
  • DME Companies
  • Group Medical Practices

What is Medical and Insurance Credentialing?

In general, credentials are utilised in a variety of fields and circumstances. Here, “credentialing” refers to either insurance credentialing or medical credentialing. Insurance credentialing and medical credentialing are terms that are interchangeable. In order to bill an insurance company as an in-network provider, physicians and other healthcare professionals, including those in hospitals, counselling services, chiropractor offices, dentist offices, optometrist offices, physical therapy offices, urgent care centres, treatment centres, social work offices, etc., must go through the credentialing process.

A provider can charge an insurance company directly if they have earned credentialing with that company. Furthermore, the majority of insurance panels offer recommendations and favourable payment rates to “in-network” doctors. The credentialing procedure is divided into two sections by several panels. There are two stages involved: contracting and credentialing. An insurance panel will verify a provider’s principal source during the credentialing process to ensure the provider satisfies the panel’s minimal requirements. The panels can also evaluate the providers’ work history and educational background by accessing the CAQH.Following the completion of credentialing, contracting will receive the provider’s application. At this point, the panel may offer the provider and the practise a “in-network” contract.

Why is Medical Credentialing and Insurance Credentialing important?​

The ability to take insurance plans from prospective patients is essential for both large and small healthcare practises to succeed in the current medical economy. Simply put, patients will “vote with their feet” and find a competing provider if they are unable to use their insurance plans at your practice—be it a family medical clinic, hospital, counselling centre, chiropractic office, dental office, physical therapist, occupational therapist, optometrist’s office, etc. Medical credentialing need not be an unwanted diversion from offering patients high-quality care, despite the fact that it sometimes is. Our services include expert medical credentialing for physicians, doctors, and nurses.

Insurance Panels: Getting Full and Closing

Sadly, as a result of the large number of healthcare professionals applying to join insurance networks, those networks are filling up quickly and occasionally even closing, making medical credentialing an increasingly difficult procedure. Having said that, some panels that identify as “closed” are actually merely adding very particular suppliers. Effectively positioning your practise and expertise might be crucial in gaining access to “closed” panels.

The licencing procedure for behavioural health professionals, such as licenced psychologists, licenced marriage and family therapists (LMFT), licenced independent clinical social workers (LICSW), licenced clinical social workers (LCSW), licenced professional counsellors (LPC), licenced mental health counsellors (LMHC), licenced professional clinical counsellors (LPCC), licenced clinical professional counsellors (LCPC), and many others, is another area of expertise. We can assist you in navigating the difficulties these nomenclature variations might cause. We recognise that a designation in one state (such as LPC or LCSW) might not be perceived as the same degree of certification in another state.

Each year, thousands of healthcare practises and providers nationwide—from New York to Alaska to Hawaii—benefit from our Medical Credentialing and Provider Enrollment services, which help them obtain credentials from the top third-party payers.

Insurance Panels: Getting more Services than ever

Because health insurance plans are covering a wider range of services, medical credentialing is becoming increasingly valuable. Parity in mental and behavioural health, less limitations on pre-existing diseases, and increased coverage of supplemental therapies are some of these modifications. Physical therapy, massage treatment, acupuncture, and other services are included in this list. But in the US, the price of health insurance has gone up correspondingly. People put a lot of money into their health insurance plans, so you can bet that when they need medical services, whether it be emergency care, general medical care, dental care, chiropractic care, optometry, mental health services, or anything else, patients will want (in fact, demand) to use their plans.

Credentialing Process We Follow

  • 1. Onboarding

    We offer advice and assist you in choosing the insurance providers you wish to be connected to.

  • 2. Application

    After receiving the required paperwork for you, we collect the most recent insurance applications and finish them on your behalf within seven business days.

  • 3. Follow up

    To ensure that every application has been received, we check in again. We actively monitor the enrolling process to make sure it proceeds smoothly and without interruptions.

  • 4. Completion

    As soon as we have confirmation of any insurance approvals, we will let you know. As soon as we have confirmation, we will forward to you any insurance authorizations. We will provide to you all pertinent data from the insurance panel. You can now see clients and submit service invoices.

Why We are Supreme in Industry ?

Increase Revenue

Medical businesses may concentrate on tasks that generate income thanks to our specialised services, resulting in higher returns and ongoing profitability.

Affordable Solutions

Medical organisations can acquire top-notch yet inexpensive support by utilising our services. Our global delivery centres are thoughtfully positioned in areas with affordable access to a competent labour force.

Minimum Processing Time

We promise faster service turnaround times because our professionals work from a number of international delivery centres spread across Asia, North America.

Advance Infrastructure

Because our employees work from a number of foreign delivery centres dispersed across Asia and North America, we promise quicker service response times.

Fast Processing

We provide quick scaling alternatives for your operations thanks to our extensive talent pool and global presence. Scale up or down seamlessly as needed, with the least amount of disruption and highest level of effectiveness.

HIPPA Compliance

You can relax knowing that we strictly follow HIPAA regulations and keep up with new needs. Our clients put their trust in us to uphold strict compliance, guaranteeing the protection and privacy of private medical information.