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Medical Credentialing

Medical Credentialing Woman

Credentialing Services

Medical Credentialing is the first step in ensuring a healthcare practice is in-network with insurance companies. Those insurers that serve your patients. This is a crucial part of any medical practice’s cash flow. Our team of credentialing experts have years of experience in working with insurance companies in order to get you and your practice credentialed expediently and affordably.

White Middle-Aged Female Credentialer

Credentialing can be a tedious and confusing task for medical providers and their staff. Done haphazardly, the process can become a nightmare. Our experienced team can streamline these processes for you and give you peace of mind that all paperwork has been completed accurately and timely. The sooner your providers are credentialed; the faster you can start seeing those patients and making money.

Medical providers tend to have many questions in reference to on-board medical credentialing protocol(s). The following blog post, Medical Credentialing (On-Boarding Process) discusses our overall protocol in detail.

The 3 Pillars of Medical Credentialing (infographic)


CAQH

The Coalition for Affordable Quality Healthcare (CAQH) is the first step in credentialing for medical providers. Without forming a profile with CAQH and keeping your information current, insurance companies will not accept or keep your credentialing status as active. Insurance companies use this universal portal as a way to maintain current information for all providers. Our educated staff of credentialing experts can help you maintain your provider’s information and set up your profile so that you’re credentialed and stay an active provider.

  • CAQH ProView Form (we create your account for you)

NPI

A national provider identifier (NPI) is a 10-digit number that every healthcare provider in the United States must obtain. It is used in billing medical claims and credentialing with insurance companies. We have an experienced team dedicated to helping you and your practice obtain your NPI numbers and stay current with your profile. Whether you are an individual practitioner, group or facility, we can help set up the correct NPI numbers for your office type and connect it to your EIN for credentialing purposes.


Recredentialing

Once a healthcare provider’s medical credentialing has been done with an insurance carrier, it’s very important that the correct measures have been taken to stay current with all of the provider’s information. Our recredentialing team knows what is needed to keep your practices information current. We work with you and CAQH to maintain and update your providers and practices information so that your cash and work flow is uninterrupted.

Medwave, Your Medical Credentialing Partner

Medwave Medical Billing, Credentialing, Contracting Company Logo CollageGetting credentialed doesn’t have to be a burden on your practice. Credentialing specialists handle everything from your initial CAQH profile setup to ongoing recredentialing requirements, allowing you to focus on patient care instead of paperwork. Medwave provides medical credentialing services to healthcare providers, helping them manage the enrollment process with insurance companies, hospitals, and healthcare networks. With our team of credentialing specialists, we handle the entire credentialing lifecycle from initial applications through ongoing maintenance.

Our services include gathering and verifying provider documentation, submitting applications to payers and medical facilities, tracking credentialing status with regular updates, and managing revalidation and recredentialing cycles to keep credentials current.

By partnering with Medwave, healthcare providers gain dedicated credentialing support, faster processing times, and accurate application handling. This allows providers to see patients and bill insurance sooner while avoiding the administrative burden of managing credentialing in-house. Our approach gives you more time to focus on patient care while we handle the paperwork.

Contact us to handle all of your medical credentialing needs and/or challenges.

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Practices Served

  • Behavioral Health
  • Primary Care
  • DME
  • Home Health
  • Urgent Care
  • Radiology
  • Cardiology
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Speech Therapy
  • Orthopedic & Rheumatology
  • Genetic Testing
  • Geriatric Medicine
  • Pharmacogenetic (PGx)
  • Fertility Preservation
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • Biologics & Specialty Drugs
  • Telestroke & Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Practices Served

  • Behavioral Health
  • Primary Care
  • DME
  • Home Health
  • Urgent Care
  • Radiology
  • Cardiology
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Speech Therapy
  • Orthopedic & Rheumatology
  • Genetic Testing
  • Geriatric Medicine
  • Pharmacogenetic (PGx)
  • Fertility Preservation
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • Biologics & Specialty Drugs
  • Telestroke & Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Recent Posts

  • Doctors Adopting Value-Based Care

    How Value-Based Care Reimbursement Works for Clinics and Hospitals

  • White Male Medical Doctor Looking at Healthcare Regulatory Updates

    Regulatory Deep Dives: Managing Healthcare Policy Changes

  • Female Medical Doctor PECOS User

    What is PECOS and its 7 Key Benefits?

  • In-House vs. Outsourced Credentialing. Two scenarios.

    Cost-Benefit Analysis: In-House vs. Outsourced Credentialing

  • Payer Contracting Experts Talking in a Healthcare Group HQ

    Payer Contracting: Maximize Your Rates

  • Credentialing Workflow Expert, a Latino Male Credentialer

    Smarter Workflows Reduce Credentialing Turnaround Time

  • Healthcare Organization Admins Talking, Walking

    ERAs vs. Real-Time Claim Status Checks: What’s the Difference?

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    How to Use Modifier 59 Correctly

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  • Why (Average Revenue Per Encounter) Matters

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