Credentialing in medical billing is the process that all healthcare service providers perform to become enlisted with insurance companies. Only trusted, vetted, and verified insurance companies include healthcare providers to serve their customers.
There are different types of credentialing, including initial credentialing and re-credentialing. Initial credentialing is for new healthcare professionals, while re-credentialing is for verifying a provider's qualifications periodically.
Application Evaluation. Completing required documentation and identifying exceptions.
Primary Source Documentation. Verify practitioner/ facility information from physicians.
Outbound Call Center
Follow-up with payers
Data Entry
Maintenance of Provider Data