Credentialing

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Reach out to us today to discuss your Credentialing needs.

Overview

Credentialing Solutions

Insurance Credentialing and Enrollment refers to the process of applying to health insurance plan networks for inclusion as a participating provider on their panels. For Commercial Insurance the process usually involves two steps: Credentialing and Contracting. First a request to participate in the health plan is sent using their credentialing application process. Many carriers use CAQH or accept a state standardized credentialing application form.

Provider Enrollment in Medicare, Medicaid, Tricare, Bureau of Workers Compensation and other government health programs is slightly different. These programs have standard forms and/or online platforms that must be filled out precisely with a vast amount of detailed information then submitted to the appropriate intermediary for review and approval.

This is a very complicated, comprehensive, detail-oriented, time-intensive work that requires special attention, experience and expertise to know exactly what information needs to be included on these insurance applications as well as follow through ability to track the applications for status until completion.

Trusted Partners

What Can You Expect?

The NCDS credentialing team has the knowledge, background and industry contacts to quickly submit your insurance credentialing and enrollment applications then consistently monitor the insurance plans to keep their approval process moving forward and timely. We have the resources to cover all your credentialing needs whether you need full enrollment or

NEW PRACTICE/GROUP ENROLLMENT

NEW PROVIDER ENROLLMENT

ADDING PROVIDERS TO THE

PRACTICE/GROUP

ADDING INSURANCE PLAN(S)

ADDING LOCATIONS

ONGOING RE-CREDENTIALING & RE-VALIDATIONS

ONGOING CAQH MAINTENANCE

INITIAL CAQH and NPI SETUP

PROVIDER DEMOGRAPHIC UPDATES

ADDRESS CHANGE UPDATES

BUSINESS/TAX ID CHANGES

HOSPITAL PRIVILEGE APPLICATIONS

CLEARINGHOUSE ERA/EFT UPDATES

Our fees can be set as hourly rates and/or per project pricing with monthly installments to keep your options fair and flexible. We have nationwide experience with all the major carriers and unique exposure to many local markets to encompass both large and small insurance plan coverage.

Why NCDS?

Nothing slips through the cracks, ever.

Cut The Clutter

Let our experts streamline your billing, and remove the frustration of traditional claim filing and receivables management.

Nothing Falls Through The Cracks

We average payment 22 days faster with -2.2% less denials than our state peers & 10 days faster with -1.5% less denials than our peers across the nation.

Automate Your Revenue Stream

As much as 98.85% of insurance claims are sent electronically with 93.59% returned via electronic remit/electronic fund transfer*, optimizing both time and cash-flow for you.

Ahead Of The Curve

Our industry connections give us early insight into healthcare system changes, government regulatory updates and access to insurance carriers and advocacy efforts.

Dedicated Consultants

Our expert staff of Certified Healthcare Billing & Management Executives will advise you personally.

Industry Pulse

Industry insight that keeps you ahead of the curve with system changes and updates

Our Promise

The NCDS Treatment

Your experience and success is of the utmost importance to our team. 

Support - You Call, we answer, 24/7. Speak with our live representatives at our Ohio office on the phone whenever you need asssistance.

Relationship - We get to know you and your practice. Through personal meetings and consultations at your office, our process is built around you and how you work.

Understanding - We help you understand your billing information. Get real advice from data in your reports, not meaningless statistics, stacks of paper and endless spreadsheets.