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Many physicians believe Medicare to be one of the best forms of insurance to accept, as they tend to pay well and expeditiously. However, Medicare also requires the most difficult credentialing process. Generally, Medicare requires four applications: Pitfalls to Avoid:
The standards for approving a physician’s credentials varies by insurer. The National Commission for Quality Assurance (NCQA) sets the standards for which physician credential approval is based. Like hospitals, the NCQA requires primary source verification of a number of credentials, including: education, training, licenses, board certifications, work history, insurance coverage, and malpractice claims history. However,…
Before a physician can provide patient care in a hospital facility, the hospital must first grant privileges to the physician. Securing these privileges should be the first step in the credentialing process, as they serve as a pre-requisite for health plan credentialing. Health plans require that physicians have privileges at participating network hospitals or they…
Medical credentialing is essential to starting or building a practice. In addition to receiving privileges at hospitals, credentialing also ensures that physicians can accept third party reimbursement from health insurance companies, Medicare, and Medicaid. With fewer patients paying out of pocket, you can expect that in order to be paid correctly, you will need to be…
Nationwide Credentialing, LLC is a company that provides physicians, urgent care facilities, ambulatory surgical centers, and durable medical equipment companies across the United States with top-notch credentialing and contract management service