Our Services
Credentialing Services
Get Credentialed Fast.
Credentialing is a complex process that requires careful documentation, verification, and compliance with insurance requirements. At Practice Claim, we make this process straightforward. Our expert team handles every step so you can stay focused on providing exceptional patient care. We have helped healthcare providers across the United States join insurance networks faster and with fewer delays.
Our Credentialing Services
We provide tailored credentialing solutions to meet the specific needs of healthcare professionals in every specialty.
– Checking through all the basic and core qualifications, certifications, and licenses.
– Handling of all paperwork needed for primary source verification.
– Conducting repeated historical checks to meet state and federal regulatory standards.
– Networking with appropriate insurance companies for integration into their insurance policies.
– Working directly with insurance companies ensuring you get the best possible deal for your practice.
– Prevention of any/ all possible shading of the already deposited credentials by updating them more frequently as needed.
– Regular updates of your credentials ensure they remain active and relevant.
– We maintain your CAQH profile and ensure it is up to date with relevant changes.
– This contains updating details, confirming details, and addressing changes to your practice.
– That might require an update to your credentialing file.
– Negotiations of payer contracts to achieve the best possible reimbursement level in the practice.
– The conditions on the terms under which payment is done have to be fair.
– Denial of contracts or appeals management along with negotiations are done.
– Application for hospital privileges will be addressed and application with necessary deals will be provided.
– Application for admitting, surgical, or specialty consultative rights will be coordinated.
– Individuals (Type 1) and organizations (Type 2) can be provider identifiers of NPIs and help with their management.
– Assistance with registration and registration renewal with the DEA for prescription drugs is also provided.
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Our Medical Credentialing Process
The provider credentialing process at Practice Claim is more than a standard procedure, it is a certified and validated method that supports the highest compliance standards. The process generally consists of the following steps:
1. Provider Survey
- We begin with a detailed survey to gather your professional background, licenses, education, and practice details.
2. Insurance Company Selection
- We help identify the insurance partners that best match your license type, location, and practice goals.
3. Application Preparation and Submission
- Our team prepares and submits CAQH profiles, manages ProView accounts, and handles payer submissions to speed up approvals.
4. Faster Approvals
- We maintain weekly follow-ups with payers to reduce the standard 60–120 day waiting period.
5. In-Network Enrollment
- Once approved, you receive in-network contracts, fee schedules, and CPT code details for billing.
6. Ongoing Compliance
- We monitor credentials daily and update them regularly to avoid lapses that could disrupt operations.
Benefits of Outsourcing Credentialing
Utilizing Practice Claim to assist in completing the credentialing process provides various ways that increase the effectiveness and profit of your facility.
Shorter Approval Times
Accelerated processing with consistent follow-ups
Improved Reimbursements
Better payment terms from in-network enrollment
Complete Compliance
All documents prepared to meet federal and state standards
Minimized Administrative Tasks
We handle forms, calls, and negotiations for you
Access to Premium Networks
Opportunities to join top-tier payer panels
Minimize Claim Daniel
Accurate submissions reduce rejections and payment delays
Why Choose Practice Claim in Credentialing
1. Competent and Experienced
We have addressed credentialing in various healthcare sectors for both individuals and large practices and facilities. We take this matter with great seriousness and have built a reputation, a high volume of our clients get through insurance and hospital credentialing easily.
2. Transparency in Processes
Credentialing is always exhausting but communication is important; we make sure that our clients are informed of every step in the process. Our clients receive regular updates about what has been done, the progress made so far, and what comes next.
3. Personalized Services
If you are a single practicing doctor or part of a large healthcare practice, we can provide you with the right credentialing services. Our approach is very flexible and focused on providing you with great results.
4. Committed Assistance
Credentialing experts assist clients in this complex process with individual assistance. We remain at your service, so don’t hesitate to raise any issues, ask questions, and seek professional help.
5. Continuous Monitoring & Maintenance
It is important to note that credentialing doesn’t end, we provide regular maintenance to keep your credentials up to date. We also manage your practice and make sure that it remains credentialed and compliant without any disruptions in operations.
Credentialing Services We Specialized in
Enrollment in Medicare and Medicaid Programs
We provide Medicare and Medicaid enrollment services by utilizing our expertise in the specific regulations to successfully secure the necessary approvals during the application process.
Commercial Insurance Credentialing
Credentialing with private insurance networks Cigna, Aetna, and United Healthcare is what we manage as well as contract management to obtain favorable reimbursement terms with major insurers.
Hospital Privileges and Credentialing
Innitiv helps in filling applications for hospital rights but is not limited to admitting, consulting, and surgical rights while dealing directly with the hospitals to fulfill all tasks related to your area of specialty.
Group Practice and Facility Credentialing
We also provide clients with practice credentialing services and health center credentialing. In this approach, multiple provider enrollments under a practice can be administered in an efficient manner.
Behavioral Health and Allied Health Credentialing
We offer credentials for practitioners in the field of mental health, physical therapists, and other allied health professionals. Our practice also helps out with payer restrictions for this sort of specialty care.
