21+
Years of Experience
1,000+
Applications Processed Monthly
50+
Specialties Served
Best Insurance Credentialing Service in USA
Insurance credentialing or healthcare credentialing is the process of getting a physician or a provider affiliated with their payer networks. Insurance credentialing is the first and most important step in managing your practice’s revenue cycle.
OSI’s insurance credentialing services are designed to save your practice time and money. Our credentialing solutions support a wide range of healthcare professionals, including:
Physicians
Nurse Practitioners
Physical Therapists
Occupational Therapists
Speech Therapists
Audiologists
Urgent Care Providers
Psychologists
Nursing Assistants and more
Comprehensive Medical Insurance Credentialing Services
Our team is dedicated to handling all your insurance credentialing services from start to finish. We can customize our services based on your requirements.
Provider Qualification Review
Healthcare credentialing verifies that a provider meets all the necessary payer standards such as:
- State medical licenses
- Malpractice insurance
- Training, residencies, and fellowships
- Affiliations and employment history
Re-credentialing Support
Most payers urge providers to perform re-credentialing every three years, to keep up with the diligent standards in maintaining a high-quality network. Our services:
- Reviewing and verifying credentials
- Managing timelines and compliance
- Communicating with payers and resolving issues
Telehealth Credentialing
Credentialing process is also crucial for telehealth providers. We can ensure that any information about your background, including the following, meet payer standards:
- Education and board certifications
- Employment history and references
- Malpractice and disciplinary history
CAQH Attestation
The Council for Affordable Quality Healthcare, Inc. (CAQH) collects credentialing information on providers to streamline the credentialing process. Our services include:
- CAQH application submissions
- Attestations and updates
- Profile maintenance for streamlined credentialing
Appeals for Closed Panels
Even if a panel is closed, payers may still accept providers with proper appeal. If the application is denied, we will appeal against the denial, highlighting your:
- Specialty experience & Clinical outcomes
- Community connections
- Advanced training and credentials
Ongoing Credentialing Maintenance
Along with maintaining your credentialing details, we can also deal with claim denials due to credentialing issues. Our services include maintaining:
- Credentialing documentation
- Contracting agreements
- Regular renewals and updates
Our medical insurance credentialing services cover but are not limited to
United Healthcare
Humana
Aetna
Medicaid
Anthem
Medicare
BCBS
Optum
We serve all 50 states
Our Insurance Credentialing Process
Each payer has their own set of rules, and any error in the process can have consequences. For any practice, we manage and maintain all your providers’ credentialing dates, expiration, and alerting dates to initiate credentialing processes.
1
Data collection from the
physicians for filing credentialing applications
physicians for filing credentialing applications
Submission of online applications
to federal, state and commercial carriers
to federal, state and commercial carriers
4
2
Choosing the right payer for practices
to submit claims and get reimbursements
to submit claims and get reimbursements
Regular follow-up with
the payers and tracking the
application status
the payers and tracking the
application status
5
3
Conducting an audit to ensure
accuracy and then filing the application
accuracy and then filing the application
Handling re-credentialing process
for providers whenever
required
for providers whenever
required
6
1
Data collection from the physicians for filing credentialing applications
2
Choosing the right payer for practices to submit claims and get reimbursements
3
Conducting an audit to ensure accuracy and then filing the application
4
Submission of online applications to federal, state and commercial carriers
5
Regular follow-up with the payers and tracking the application status
6
Handling re-credentialing process for providers whenever required
FAQs
Why is insurance credentialing essential for you?
If you are credentialed, you can deliver treatment to the patients who are enrolled in specific insurance plans. The cost of the services you provided can be billed directly to the insurance company where the patient is enrolled. Being credentialed can enhance the number of patients accessing services from your healthcare facility.
What is CAQH?
The Council for Affordable Quality Healthcare (CAQH) is a third-party vendor that payers may use to collect provider data for credentialing purposes. Having a complete CAQH profile is crucial in insurance credentialing, as it streamlines the process for practitioners by reducing paperwork.
Is there any guarantee I will get the insurance panel I chose?
Our service-oriented credentialing experts can help identify potential insurance companies if you are fully licensed. If the panels have established criteria, we will discuss how to be successful in the credentialing process. We will focus on getting you the most out of your credentialing investment but we are unable to assure you that the insurance panels will accept you.
What documents are needed for credentialing?
For insurance credentialing, our team may verify many provider documents including State Medical License, Certificate of Malpractice Insurance (COI), Federal DEA License, State DEA License, Board Certification(s), Current CV, Collaborative Agreement (required for Nurse Practitioners only), and more.
What is the approximate duration of the medical credentialing process?
The process of credentialing takes between 90-120 days. Once you have signed up with OSI, we start gathering information for the applications immediately and promptly submit them to insurance companies. We proactively communicate with insurance companies regarding your application and ensure that they are processed and approved as soon as possible.