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Medical credentialing and physician contracting services play crucial roles in the operations of healthcare providers, ensuring compliance with insurance carrier standards and facilitating patient access to their expertise. However, the credentialing process is intricate and time-consuming, involving numerous documents and stringent requirements. MBP Billing and Coding Solutions provides premier credentialing and physician contracting services to assist providers in navigating these challenges, allowing them to concentrate on delivering high-quality healthcare services to their patients. Understanding the difficulties of credentialing and physician contracting, our expert team possesses in-depth knowledge of insurance carrier criteria and regulatory frameworks. With established relationships with major healthcare carriers, we efficiently guide our clients through the credentialing and contracting processes, ensuring exceptional service delivery and optimal outcomes.
MBP Billing and Coding Solutions has expertise in healthcare provider credentialing and contracting. Our expert team offers comprehensive management of the entire process to ensure a seamless experience for your practice. From gathering required documents to completing the credentialing process and addressing payer inquiries, our team handles all aspects from start to finish. Recognizing the criticality of re-credentialing deadlines, we assign a dedicated team to track and initiate the process for your practice. We collaborate closely with you to complete initial applications, conduct necessary background checks, and secure timely approvals for your providers.
MBP Billing and Coding Solutions maintains a dedicated team available 24/7 for Physician Credentialing, specializing in continuous handling of credentialing tasks to meet the needs of healthcare organizations and providers anytime.
We supervise the creation and maintenance of CAQH and PECOS credentialing portals, ensuring continual accuracy of your information. We conduct the enrollment and revalidation for healthcare providers seeking Medicare program participation. We streamline the credentialing process across various insurance plans, aiming to standardize this process nationwide for healthcare providers in the United States.
Managing contracting issues and ensuring data integrity are crucial for effective Physician Credentialing. Healthcare organizations should establish clear contractual terms, comply with legal requirements, and implement robust data management practices to facilitate a smooth and accurate credentialing process for providers .Our team diligently handles any contracting issues and conducts regular audits to maintain data integrity.
At MBP Billing and Coding Solutions We oversee the ongoing process of Medical Credentialing follow-up, ensuring the healthcare providers maintain their qualifications, comply with regulations, and consistently meet healthcare network standards. Our commitment ensures that healthcare professionals maintain their credentials and uphold the necessary standards for medical practice.
Ensuring compliance with Physician Credentialing is essential in healthcare, guaranteeing that healthcare providers satisfy the required criteria to practice medicine and engage with healthcare networks. Compliance involves following diverse regulations, guidelines, and best practices. MBP Billing and Coding Solutions guarantees adherence to the National Committee for Quality Assurance (NCQA) standards and manages training on daily basis to stay up-to-date with evolving requirements and standards within the industry.
Credentialing and contracting constitute vital aspects of every healthcare practice. MBP Billing and Coding Solutions provides comprehensive physician credentialing and contracting services aimed at expanding your patient reach and enhance your practice. With a specialized team of experts, we excel in simplifying the enrollment procedure, optimizing your revenue potential while saving you time and reducing administrative burdens.
Precision in Medical Billing and CredentialingMBP Billing and Coding Solutions stands out as a renowned provider in the medical billing service industry. Our reputation is built on consistently delivering precise and prompt outcomes, which effectively boost revenue for our valued clients. Utilizing cutting-edge technology and expertise, we streamline the billing process, reduce errors, and enhance productivity, all while delivering exceptional client support. Our team at MBP Billing and Coding Solutions comprises highly skilled and extensively experienced specialists in Medical Billing and Coding. Beyond simply managing billing requests, our commitment lies in passionately ensuring your economic prosperity in the Revenue Cycle Management Sector.
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We are helping healthcare physicians across the United States tackle their medical billing and credentialing challenges. Our team of experts specializes in key areas known for significantly improving billing efficiency and accuracy. If you're seeking a reliable medical billing company, look no further. Contact us today to learn more about our comprehensive services!
TESTIMONIALS
"MBP Billing and Coding Solutions has been a game-changer for my practice. Their expertise in managing credentialing and billing processes has allowed me to focus entirely on patient care. Their team is incredibly reliable and always ready to assist. Highly recommended!"
"Working with MBP Billing and Coding Solutions has significantly streamlined our billing processes. Their proactive approach and meticulous attention to detail have resulted in faster reimbursements and reduced administrative burdens. Their services are indispensable to our clinic."
"The team at MBP Billing and Coding Solutions is exceptional. They handled our credentialing and contracting with such efficiency that we experienced no downtime. Their dedication and professionalism ensure our practice runs smoothly, and we couldn't be happier with their services."
"I can't thank MBP Billing and Coding Solutions enough for their outstanding service. Their regular follow-ups and audits have kept our credentialing up-to-date and compliant. Their expertise has saved us time and money, making them an invaluable partner for our office."
"MBP Billing and Coding Solutions has exceeded our expectations in every way. Their comprehensive understanding of the credentialing process and prompt handling of contracting issues have been crucial for our practice. Their support allows us to maintain our focus on delivering excellent patient care."
Common QueriesInsurance Credentialing verifies the qualifications and experience of healthcare providers for insurance network inclusion. It involves submitting an application and supporting documents like licenses, certifications, and malpractice insurance
Necessary documents vary depending on the insurance plan and the type of healthcare provider. Here is a list of some basic documentation that is usually required. Documents for individuals:
Credentialing is a critical step in ensuring that healthcare providers are paid correctly for their services and don't suffer any financial losses. In order to obtain reimbursement for medical expenses, doctors and other healthcare professionals must provide insurance companies with proper verifications
The turnaround time for insurance carriers varies, so there is no single answer to this question. Major Insurance normally takes between 90-120 days to complete the process, while smaller carriers and insurance plans may take longer.
When providers submit a participation request to a commercial carrier, they need to complete two processes. The first is credentialing, where the carrier verifies all provided credentials and presents them to their committee for approval. After providers are approved by the credentialing committee, they are directed to the contracting process, where their participation is approved, and they are provided their effective date
If any insurance company denies your credentialing application, you have the right to appeal the decision. To file an appeal, you need to submit a letter to the insurance company that clearly and professionally explains why you believe you should be credentialed. In your letter, you should specifically address the reasons why your application was denied and include any additional documentation, such as letters of recommendation from colleagues or patients.
Once you have submitted your appeal letter, the insurance company will review it and provide a decision. If your appeal is successful, you will be credentialed with the insurance company. However, if your appeal is denied, you may file a complaint with your state's insurance commissioner
Medicare providers must revalidate every 5 years, while DMEPOS suppliers must revalidate every 3 years. Individual providers can use PECOS online or fill out the paper application. Groups or suppliers must complete the mandatory application. Establishing Electronic Funds Transfer is required for group records. Responding to the revalidation letter within 60 days is crucial. Failure to respond in time may result in the termination of billing privileges
NPI 1 functions as your personal identification within the healthcare field, similar to a social security number. It remains linked to your professional journey and is exclusively assigned to you as the practitioner delivering services.
On the other hand, NPI 2 is an identifier for organizations, representing the location where services are provided. It can be associated with the employer's company name for those working under an agency or with their business name for those in private practice.
We strongly recommend that businesses with a tax ID obtain an NPI 2. This is essential for establishing contracts with insurance panels at the organizational level, ensuring proper billing and payment for services. This becomes especially important as businesses and teams expand.
Additionally, certain insurance panels like Medicaid, Medicare, and BCBS require an NPI 2 for credentialing if the business has a tax ID
Insurance panels often begin their process by referring to the information in your CAQH profile. When a healthcare provider submits an application on the panel's website, the application undergoes a thorough review, and during this review, the panel frequently consults your CAQH profile to verify the information you've included in your application
Credentialing is the procedure to assess a provider's suitability for inclusion in an insurance network, conducted before their membership. Re-credentialing, which is performed periodically, typically every 1-3 years following the initial approval, aims to confirm the accuracy and currency of the provider's details on the insurance panel.
Certainly, when you apply for credentialing through our organization, you have the freedom to choose the specific insurance networks you want to be affiliated with, and you can also specify the ones you'd like to exclude. Typically, most doctors working in outpatient settings opt to become credentialed with approximately 7-8 insurance providers. On the other hand, hospital-based physicians often choose a broader range, usually around 10-15 payors, to accommodate patients with various insurance plans who seek treatment within the hospital. In situations where physicians practice in the tristate area, which denotes a location at the meeting point of three states, such as our physician-owned practice, it is customary to seek credentialing with as many as 25 different insurance networks
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MBP Billing and Coding Solutions offers expert medical billing services to optimize revenue and streamline operations for healthcare providers.
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