Credentialing/ EDI Services

Enrollment and Provider Credentialing Services for the Entire State

With Claim x Care provider credentialing services, you can make sure your healthcare organization keeps up its high standard of care without any delays or needless worry.

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For Healthcare Organizations Passionate About Quality Healthcare and Streamlined Operations

Verifying a healthcare provider’s credentials—such as their training, experience, etc.—ensures that they can deliver high-quality treatment, which is why credentialing is important when joining insurance networks. This procedure is required by health insurance providers such as UnitedHealthcare, Anthem, Aetna, Cigna, Blue Cross Blue Shield, CMS/Medicare, Medicaid, and Humana.

Successful healthcare organizations understand how time-consuming and resource-intensive the credentialing/enrollment process and ongoing maintenance are.

Claim x Care offers medical practices and healthcare organizations a quick, cost-effective method to quickly and minimally interrupt credential verification.

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A Credentialing Procedure That Will Enhance Rather Than Complicate Your Business

If not rigorously supervised, the time-consuming and resource-intensive initial credentialing, record-keeping, and re-credentialing procedures may result in further delays and stress. When the application is submitted, provider credentialing starts, and it concludes when the contract is fully finalised and has an effective date. A lot of applications are marked as incomplete or abandoned because contract signatures are lacking or there has been no follow-up.

Knowledge of Credentialing in a Variety of Specialisations

  • Physicians
  • Physical Therapists
  • Nurse Practitioners
  • Occupational Therapists
  • Physician Assistants
  • Dentists
  • Clinical Psychologists
  • Dietitian/Nutritionists
  • Registered Nurses
  • Clinical Social Workers
  • Chiropractors
  • Optometrists
  • Occupational Therapists
  • Podiatrists
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We Offer Credentialing Choices

Medical credentialing is a continuous process. It needs frequent upkeep and upgrading, and there are a number of underlying dependencies (such licences) that demand ongoing consideration. The certification and maintenance specialists at Claim x Care assist medical providers and organizations in avoiding interruptions by offering continuous assistance.

Medical Credentialing & Enrollment

We provide healthcare organizations one-time provider credentialing services. It is great for medical practitioners in an administrative bottleneck and excludes maintenance and re-credentialing assistance.

  • Generate and provide a checklist of requirements.
  • Accumulation of documentation.
  • Submissions to selected payers.
  • Collection from payers and delivery of documentation.
  • Follow-ups with payers and feedback to you.

Medical Credentialing & Enrollment + Continuous Support

We offer continuous assistance, upkeep of records, oversight of due dates, and investigation of modifications to laws and industry best practices.

  • Preparations and checklist generated.
  • Accumulation of documentation.
  • Submissions to selected payers.
  • Follow-ups with payers and feedback to you.
  • Collection and delivery of documentation.
  • Monitoring licensing renewal dates.
  • Managing recredentialing and revalidation.

What Details Physician Credentialing Requires

In order to verify that a healthcare practitioner satisfies the requirements specified by insurance companies, healthcare organizations, and regulatory agencies, a thorough examination of the provider’s training, experience, and credentials is necessary for physician credentialing.

  • NPI Number
  • Practice information
  • CAQH profile (up-to-date)
  • Medical License
  • Insurance information
  • Verification of original sources and licence to practise
  • DEA license
  • Education: degrees and transcripts
  • Board certification
  • Malpractice Insurance
  • References
  • Past history of malpractice claims (revocations, suspensions, etc.)
  • Login information for insurance programmes (Medicaid, Medicare (Pecos), Availity,)

Boost Your Revenue Cycle With Supporting Services for Claim x Care Credentialing

To find out more about our auxiliary services, which include medical licencing and contract negotiation and are intended to complement one another to increase your company’s reimbursement income, get in touch with us.

DEA Certificate & Renewal

CLIA Registration

CDS Licensing

Group Licensing

Providers State Licensing

Healthcare Recruitment

Payer Contract Negotiations

Reimbursement Audits

Prepare for Processes and Avoid Interruptions

Utilise our all-inclusive checklist to compile the required data and tactics. This will facilitate the credentialing and enrolling process and assist you get past difficulties.

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Why Select Claim x Care as Your Reliable Partner for Credentialing?

Select Claim x Care as your go-to credentialing partner to benefit from simplified procedures, industry knowledge, and customized solutions that promote the growth of your healthcare company.

Vast Nationwide Experience

Having worked in the healthcare administrative support field for more than 11 years, claim x Care has a thorough grasp of the field.

Effective Extension of Provider Networks

With us, you can easily grow your provider network by onboarding additional healthcare professionals quickly and efficiently by using our effective credentialing services.

Saving Time & Reducing Disruptions

Our teams can deliver at a remarkable pace, saving you significant time and minimising operational disruptions, thanks to our experience in credentialing, maintenance, and re-credentialing.

Improved Patient Experience

Using our offerings By relieving your team of time-consuming paperwork and credentialing administration, you can improve the patient experience by giving them more time to concentrate on patient collaboration.

Compliance Assurance

We guarantee that your credentialing procedures adhere to industry standards, reducing risks and improving practice efficiency.

Personalized Pricing

By personalizing our services and choosing flexible pricing choices that are catered to your unique requirements and financial constraints, you can take charge of your cash flow.

What's Our Client Says

Claim X Care

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Mike David
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The most diligent and competent billing business is Claim X Care. Claim X Care verifies the accuracy of their billing. They have excellent expertise of physician billing.
John Doe
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Claim x Care has been a huge assistance with our excellent A/R. They are constantly so eager to assist and do the work quickly..
Jack
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For accrediting our practice, I went with Claim x Care. The crew helped us along the way and was courteous, understanding, and quick to respond.
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Frequently Asked Questions (FAQ’s)

What is revenue cycle management (RCM) in healthcare?

The process of overseeing the financial facets of patient care, from scheduling and registration to claim filing and payment collection, is known as revenue cycle management in the healthcare industry. It entails duties like coding, billing, accounts receivable administration, and confirming insurance eligibility.

Revenue cycle management is offered by Claim x Care as a whole service or in segments that may be chosen as a la carte offerings. In all we do, we tailor our solutions to the particular healthcare provider and practice management style, making our service to you exceptional.

How can RCM services benefit my healthcare organization?

Your healthcare company may gain from revenue cycle management services by increasing cash flow, decreasing claim denials, increasing revenue collection, and simplifying administrative duties. Revenue cycle management services may improve practice management, boost efficiency, improve financial performance, and free up staff members to concentrate on patient care by using knowledge, technology, and best practices.

According to our observations, when revenue cycle management is done well, it will also result in a better patient experience, which will raise the number of favourable reviews and eventually lead to patient expansion.

What types of healthcare providers can benefit from RCM services?

Numerous healthcare organizations, such as hospitals, doctor offices, clinics, ambulatory surgical centres, and medical billing firms, might benefit from revenue cycle management systems. Any organization that handles medical billing and revenue collection, regardless of size or specialism, may gain from more efficient revenue cycle management procedures.

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