The Practice Care Medical Credentialing Services

Tired of delays and complex paperwork holding back your practice? At The Practice Care, we specialize in simplifying the credentialing process for Medicare, Medicaid, commercial insurance, and workers’ compensation. Our medical credentialing services are designed to meet your unique needs, ensuring fast approvals and seamless enrollment.

Say goodbye to credentialing headaches and focus on what matters most—patient care. Get the support you deserve and streamline your practice with our expert services today.

Provider Enrollment and Credentialing Services

The process of provider enrollment and credentialing can feel overwhelming and time-consuming. At The Practice Care, we simplify the journey, ensuring your credentials are accurate, up-to-date, and compliant with all-payer requirements.

Commercial Insurance Credentialing

Credentialing with commercial insurance payers can be a lengthy and complex process due to varying eligibility criteria and plan requirements. We understand that every insurance company has its own set of guidelines, and missing even the smallest piece of information can delay your ability to see patients. The Practice Care ensures that your applications are complete and accurate, helping you avoid unnecessary delays and start seeing patients sooner.

Revalidation & Re-Credentialing

Maintaining active status with insurance payers is critical for continuous reimbursement. Revalidation and re-credentialing are required periodically to ensure you remain in good standing. At The Practice Care, we proactively manage this process, ensuring timely updates to your demographics and practice information. We handle your revalidation with Medicare, Medicaid, and commercial insurers, so you never miss a beat or face penalties.

Seamless Credentialing for New Providers

Onboarding new providers shouldn’t slow down your practice. At The Practice Care, we specialize in getting new healthcare professionals credentialed quickly and accurately. We handle the intricate details—from submitting board certifications and malpractice insurance to ensuring professional references are in place. Our expert team ensures that your new providers are enrolled with the right insurers, so they can start treating patients without delay, keeping your practice running smoothly.

Our Medical Credentialing Solutions

At The Practice Care, we offer affordable, efficient, and fully customized credentialing solutions that keep your practice running smoothly. We ensure your providers are enrolled, re-credentialed, and compliant with all insurance requirements, saving you time and reducing the administrative burden.

New Enrollment

Our team helps new healthcare providers quickly and accurately enroll with insurance companies, Medicaid, Medicare, and commercial payers. By ensuring all required documents are submitted correctly, we eliminate delays, so providers can start seeing patients sooner.

Credentialing

We ensure that your providers’ credentials, including board certifications, licensure, and professional references, are up-to-date. Our team works with you to keep your records accurate, compliant, and ready for seamless interactions with insurers.

Re-Credentialing

Staying compliant is key, and we take the hassle out of re-credentialing. We proactively review and re-verify your providers’ credentials to ensure they meet current payer requirements, reducing the risk of delays and penalties.

Licensing

Keeping your state licenses updated and compliant is critical for your practice's operations. Our credentialing specialists assist with obtaining and renewing medical licenses, ensuring you meet all state-specific regulations and avoid unnecessary disruptions to your practice.

IPA Enrollment

Joining an Independent Practice Association (IPA) can expand your practice’s network, but the enrollment process can be complex. Our team streamlines IPA enrollment for new healthcare providers, simplifying the paperwork and accelerating approval.

DEA & CLIA Registration: Ensuring Compliance for Your Practice

For healthcare providers prescribing controlled substances, obtaining and renewing a DEA certificate is a must. Our expert team handles the entire process, ensuring your certificate is active and in compliance with federal regulations. With our help, you can prescribe and manage controlled substances seamlessly, tailored to your specific specialty, without the administrative stress.

Additionally, we assist healthcare providers and laboratories with the Clinical Laboratory Improvement Amendments (CLIA) registration. Whether you’re conducting tests for diagnosis, prevention, or treatment, we streamline the CLIA registration process, ensuring you meet all federal requirements and can offer essential testing services to your patients.

Why Outsource Medical Credentialing Services to The Practice Care?

Outsourcing your medical credentialing services to The Practice Care offers a range of benefits that streamline the process and save your practice time and resources. Our expert team ensures compliance, accurate submissions, and proactive follow-ups, so you can focus on patient care and revenue growth.

Aggressive Follow-Up

Credentialing applications often face long delays due to insurance plan backlogs. We ensure your application is not overlooked. Our team regularly checks the status, maintaining thorough records of all follow-ups until your participation is confirmed and you’re ready to start treating patients.

Expert Application Completion

Even small application errors can lead to denials or delays. Our experienced team ensures every field is filled out correctly, from practice addresses and licenses to services offered. This careful attention to detail guarantees that your application is approved on the first submission.

Compliance with NCQA Standards

Our services adhere to the National Committee for Quality Assurance (NCQA) standards. This ensures your practice meets the highest quality benchmarks, giving you access to exclusive preferred partnerships, and networks, and expanding your patient base.

Continuous CAQH Monitoring

Keeping your CAQH profile up-to-date is essential for maintaining active status with insurers. We handle all necessary updates and re-attestations to ensure your information stays current, preventing unnecessary delays during re-accreditation and enabling smoother interactions with insurance companies.

Simplified Physician Credentialing

Physician credentialing is often complex, requiring a significant amount of documentation and continuous updates. Our credentialing services simplify the process, ensuring that all your licenses, certifications, and regulatory requirements are met so you can stay focused on patient care.

Ongoing Support & Consultation

Beyond credentialing, we provide continuous support and consultation to help you stay compliant with changing regulations. Our team keeps you informed and ensures that you are always in good standing with your insurers.

Faster Insurance Enrollment

We expedite the insurance enrollment process, ensuring that you’re able to accept a wide range of payers quickly. This results in faster reimbursement and fewer disruptions in your practice's cash flow.

Seamless Medical Credentialing Process

We’ve streamlined the credentialing process to ensure it’s quick, efficient, and hassle-free. Our simple 4-step process guarantees that your credentials are verified and approved without unnecessary delays.

Initial Consultation
We begin by understanding your unique needs, reviewing your practice details, and gathering all necessary documents for the credentialing process.

Application Submission
Our team carefully completes and submits your credentialing application to all relevant insurance payers, ensuring all required information is accurate.

Follow-Up & Monitoring
We proactively follow up on your application, checking the status regularly, and keeping you updated until the approval process is complete.

Final Confirmation & Ongoing Support
Once approved, we confirm your participation with insurers and continue to provide ongoing support, ensuring your credentials stay up-to-date and compliant.

Who Can Benefit from Our Credentialing Services

Physicians
Nurse Practitioners
Physicians Assistants
Dentists
Chiropractors
Physical Therapists
Podiatrists

Psychologists
Medical Groups
Hospitals
Home Health Providers
Behavioral Health Providers
Laboratories
Urgent Care Centers

Frequently Asked Questions

Which documents are required for insurance credentialing?

For insurance credentialing, the required documents typically include your medical license, board certifications, malpractice insurance, government-issued ID, DEA certificate (if applicable), NPI number, and a detailed CV or resume. Requirements may vary depending on the payer or insurance plan.

How much time does it take to enroll with Medicare?

Medicare enrollment can take anywhere from 30 to 90 days, depending on the accuracy of the application and the specific Medicare contractor. Delays can occur if any information is missing or incorrect, so it’s important to ensure all documents are submitted properly.

What is a CP575?

A CP575 is a notice issued by the IRS when you receive your Employer Identification Number (EIN). This document verifies your practice’s legal structure and is essential for credentialing with Medicare, Medicaid, and insurance providers.

What is the difference between credentialing and contracting?

Credentialing verifies a provider’s qualifications and background, while contracting involves negotiating and agreeing to terms with insurance companies. Credentialing is required before contracting, and both processes are essential for network participation.

How often do I need to re-credential?

Most insurance companies require re-credentialing every 3 years. However, certain programs like Medicare and Medicaid may require updates or revalidation more frequently. It’s essential to keep track of deadlines to prevent any disruptions in your network participation.

Can I credential multiple providers at once?

Yes, you can credential multiple providers simultaneously. Our team can manage the credentialing process for your entire practice, saving you time and ensuring compliance for all your healthcare providers.