Credentialing

Credentialing is a critical process that involves the thorough verification and assessment of healthcare providers’ qualifications, experience, and relevant details. This process ensures that they meet the stringent requirements established by insurance companies, government agencies, and healthcare facilities. By successfully completing credentialing, providers become eligible to participate in various insurance networks and receive proper reimbursement for the medical services they offer.

1. Verification : At IPClinical, we meticulously verify all essential provider information and documents necessary for the credentialing process. This comprehensive assessment covers the provider’s personal details, rigorous checks on medical licenses and board certifications, a thorough review of education and training history, a detailed examination of work experience, and a careful evaluation of malpractice history. Additionally, we obtain and validate references and other pertinent information.

Ongoing Monitoring

Credentialing is not a one-time event but an ongoing commitment to maintaining quality standards. Our dedicated team of experts ensures that providers undergo re-credentialing at regular intervals to confirm their continued qualification and adherence to required standards. We proactively monitor expiration dates, gather necessary documentation, and submit timely applications to guarantee uninterrupted license renewal.

2. Data Security and Management: Your credentialing data is of utmost importance to us. We securely collect, store, and manage all your credentialing information in a robust and highly secure cloud-based system. Your data’s safety and confidentiality are our top priorities.

3. Preventing Revenue Loss: Proper credentialing is essential for safeguarding the financial health of medical practices. Neglecting this process can lead to denied or delayed reimbursements from insurance payers, resulting in potential revenue loss. Our thorough credentialing services help ensure that you receive the reimbursements you rightfully deserve.

4. Enhancing Reputation: Medical credentialing not only secures financial stability but also enhances your professional reputation. This elevated reputation fosters several advantages, including:

  • Building trust in your services among patients.
  • Fostering client loyalty and retention.
  • Establishing recognizable brand identity.
  • Reducing marketing costs through word-of-mouth referrals.
  • Elevating the overall value and professionalism of your business.

Why Choose IPClinical for Provider Credentialing:

  • Our track record boasts a 100% success rate in credentialing applications, typically taking 90-120 business days to become an in-network provider.
  • Our unwavering commitment to follow-up ensures that your application is not only received but also processed with 100% accuracy.
  • We excel in situations where panels are closed by actively seeking alternate third-party administrators and independent physician associations offering compatible health plans.
  • We maintain your practice’s data up to date with key organizations, including NPPES, CAQH, CMS, and various insurance providers.
  • We revisit your contracts after one calendar year to negotiate for higher reimbursement rates, thus continually working to enhance your practice’s financial success while revalidating information with each payer for each provider.

Choose IPClinical for comprehensive and reliable provider credentialing services that safeguard your financial well-being and elevate your professional reputation in the healthcare industry.

OUR SERVICES

IPClinical is committed to providing the best possible experience for our clients. That’s why we use the latest customer relationship management software to help us stay connected with you and your needs. Our CRM software allows us to track your interactions with us, so we can provide you with personalized service.