Provider Enrollment and Credentialing

Provider Enrollment and Credentialing

Advantage Billing also providing Quality Medical Coding services at very reasonable rates. We provide quality medical coding services for physician groups, facilities and surgical centers allowing them to focus their attention on their practice and patient care.

Our team consists of professional and qualified medical coders, which are CPC and CPMA certified from AAPC and have profound experience in their field. Our exceptional professionals are well equipped with the knowledge and expertise, to get their job done efficiently.

Our goal at Advantage Billing is to find a better way and we have worked to build medical coding solutions that solve real coding problems, create real efficiencies and have a real impact on improving revenue and cash flow.

Enrollment and credentialing are not only a critical component of developing a practice that delivers the highest level of patient care rather it is crucial for insurance reimbursement. States and insurance providers determine which medical providers meet their requirements through the process of enrollment and credentialing. It is necessary for insurance reimbursement and to ensure your patients are receiving high-quality care from qualified providers.

Advantage Billing offers enrolment and credentialing services to the clients (to the full spectrum of specialities) and ensures their satisfaction by doing the enrolment and credentialing process as per the credentialing standards and guidelines implemented by the National Committee of Quality Assurance (NCQA). Our highly experienced team members will provide the major provider enrolment and credentialing solutions as discussed below.

  • Enrollment of healthcare provider with insurance companies or payers (Government as well as Commercial)
  • Creating ERA/EFT set up with insurance.
  • Confirmation of enrolment status with carriers & plans
  • Re-Certification & Re-validation with Government and Commercial payers.
  • Ensure maintenance of provider’s data and creating web portals of the carriers.
  • Enrollment and Credentialing requirements vary state to state, even medical facilities to insurance carriers. The major credentialing requirements include:
  • Education and Training
  • Hospital affiliation
  • State license(s) and DEA license
  • Provider enrollment application
  • Board certification
  • Malpractice insurance certificate
  • Sanctions disclosure and criminal background disclosure
  • Background Screening etc.