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Insurance Credentialing

Insurance credentialing has become one of the most important aspects of the medical billing process in the recent years. In the past, doctors and healthcare establishments could afford to deny insurance and ask the patients to pay upfront. The patients would handle the insurance claims process themselves and get the compensation directly from the insurance company.

That’s no longer possible because insurance is more widespread and organized now and most patients will only visit practices that accept insurance for their insurance company. We at SMS Medical Billing can help you with that process.

What is insurance credentialing?

This is the process of becoming qualified and affiliated with an insurance company and becoming a part of their approved list of practitioners. This affiliation can simplify the claims process and allow you to accept the patients’ insurances. You can be affiliated with a number of different insurance companies in order to provide your customers with all possible options.

If you don’t accept the patient’s insurance or don’t provide options to them, they’ll seek competing practices instead of sticking with you. That can prove to be very detrimental to your establishment. The medical field is competitive so it’s important to do everything you can to stay ahead of the game.

Insurance companies

We’re familiar with the insurance credentialing process of almost all of the popular insurance companies in the US. We will help you get in the network of companies like Medicare, Medicaid and it’s HMO’s along UnitedHealth Group, Anthem, Cigna, Aetna, Humana, etc. You don’t need to worry about the application process and can focus on your patients while we make sure your practice in a part of the insurance company’s network.

As we’re familiar with the process, we can make sure you have the right application and won’t be denied admission.

What do we need?

In order for us to complete the application, we need some documentation and support from you and this includes:

● CV
● License
● Medical degree diploma
● Board certificate
● Malpractice declaration page
● Notice of incorporation from IRS
● Voided check with corporation name for medicare
● Acceptance letters from hospitals you have privilege associations with
● Professional references from three trusted authorities
● Hospital affiliation letters
● Address, phone, and fax number and other such contact details of your practice.

We will also require some other documentation but you can discuss that with our expert before the application. If you want to know more about our services, don’t hesitate to get in touch with us at SMS Medical Billing. We’ll be happy to answer any questions you might have.