Expert Credentialing & Provider Enrollment Services That Accelerate Provider Approvals Across the US
A provider may be fully licensed, certified, and qualified to treat patients and yet earn zero revenue because he or she is not credentialed and enrolled correctly. Ineffective credentialing is one of the most common causes of lost revenue in the industry, and not because of rejected claims. It’s because of the several months of patient treatment that cannot be billed.
Cueclaim offers credentialing and provider enrollment services for physicians, hospitals, private practices, specialty clinics, and ambulatory care centers in the US. Our experts control the entire credentialing process, including the initial application and re-credentialing.
- Credentialing Services
Credentialing Services That Protect Your Revenue From Loss
Credentialing is an intensive documentation and deadline-oriented process. One missing piece of documentation or an expired certificate may cause the entire process to freeze for a few weeks. Each week of waiting during this period means a week where the provider loses out on billing any services provided under their name.
The Credentialing team at Cueclaim takes the lead to ensure the process moves smoothly from start to finish so that your providers can concentrate on making money rather than getting approvals.
Why Credentialing Accuracy Matters
- Credentialing Services
What Our Credentialing & Enrollment Service Includes
- Initial credentialing application is the submission of complete providers’ applications to insurance networks and payers.
- Primary source verification assistance verifies that licenses, certifications, and educational documents comply with the requirements of the payer and the regulatory body.
- Payer enrollment management manages every step of the process until the provider is approved and live.
- Credential reapplication or expiration tracking manages the renewals of the credentials to ensure providers do not expire out of network unexpectedly.
- CAQH profile management ensures provider information is up-to-date in the database used by the payers for their verification purposes.
- Clean-claim First
Every claim reviewed, scrubbed, and tracked from submission to payment.
Why Providers Choose Cueclaim for Credentialing & Enrollment
Different payers will have different requirements when it comes to the submission of claims, timeframes within which they need to be processed, and how much information they require from the provider after their submission. Cueclaim works for all providers, including those who offer primary care, cardiology, orthopedics, neurology, gastroenterology, dermatology, behavioral health, and pain management services.
Expert Billing Specialists
Our credentialing department is fully dedicated to managing applications and working with payers in order to find missing paperwork and expired certifications that may impede your application process.
Technology Integration
We integrate with all major CAQH and payer enrollment portals to make sure that your provider data is correct and avoid redundant paperwork entry.
Revenue Cycle Optimization
Credentialing is the first step in the revenue cycle for any practitioner's revenue potential. Perform it correctly from the start to avoid losing any revenue.
Real-Time Reports
We provide you with continuous reports about the status of your applications, upcoming deadlines, and all open payer requests.
Our Credentialing & Enrollment Process
Documentation
We gather licenses, certifications, educational documents, and other necessary documents for each application.
Application Completion
Provider applications are filled out correctly and sent to the appropriate payers and networks.
Continuous Tracking & Follow-Up
We follow up with the payers through the entire process to make sure applications do not get stuck.
Approval Verification
After approval, enrollment information is verified and passed along to your billing team.
Continuous Recredentialing
Continuous tracking of renewal deadlines ensures that providers do not suddenly lapse out of networks.
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Frequently Asked Questions
What is provider credentialing in healthcare?
Provider credentialing refers to the process of verifying the credentials of the healthcare provider by checking their licenses, certifications, education, and training requirements.
What is the difference between credentialing and provider enrollment?
Credentialing refers to verifying the qualifications of the provider, while the enrollment process refers to the process of registering the provider with certain insurance payers.
How much time does the credentialing process take?
The process of credentialing and enrollment of the provider takes up to 60 to 120 days depending on the payer; hence, it is necessary to apply promptly.
What happens in case a provider is not properly credentialed?
If a healthcare provider is not credentialed or enrolled with a certain insurance payer, the insurance payer may deny the claim regardless of its correctness.
Does Cueclaim handle re-credentialing and renewals?
Yes. Cueclaim manages the recredentialing process automatically by tracking the expiration date of the credentialing process of each credentialed provider.
Don't let your revenue suffer due to poor credentialing and enrollment.
Let Cueclaim assist with their highly qualified professionals in the field of credentialing and provider enrollment. Cueclaim is dedicated to assisting healthcare providers all across the United States to obtain faster approvals, minimize denials, and optimize reimbursements.