At 1ˢᵗ Credentialing we know that when our clients place their trust in us, we take that responsibility seriously by communicating with our clients to create a transparent and collaborative partnership.
Healthcare organizations of every size realize that hiring 1ˢᵗ Credentialing is the most economical and efficient way to solve their credentialing needs. We have the training, expertise and commitment it takes to keep a complex process moving forward at all times.
1ˢᵗ Credentialing supports healthcare practices of all sizes - from health systems, to community hospitals, to large group practices, to smaller organizations. We help get your providers up and practicing as fast as possible.
Learning more about the credentialing process benefits us and our clients. 1ˢᵗ Credentialing offers regular videos and newsletter updates to bring our clients and those interested in innovations in credentialing up to speed.
The fact is that both are a type of credentialing process: Medical credentialing generally refers to primary source credentialing, which is a type of a professional background check on doctors and other health care providers.
Payer enrollment (sometimes known as provider enrollment), on the other hand, is the process by which a medical provider gets entered onto insurance plans, networks, Medicare and Medicaid so the provider can be paid for services rendered to those patients.
Payer Enrollment Basics
Most providers choose to be enrolled with major health plans in order to be considered “in-network.” This is an important distinction because patients almost always prefer to be seen by in-network health care providers. Plan participants usually realize cost savings by using in-network providers.
In order for a medical provider to be enrolled with a payer – a network, plan, Medicare or Medicaid – they must meet specific criteria to be credentialed. At this point, an enrollment specialist like 1st Assistant can be very helpful to the process.
It’s important that all application information be complete – if anything is missing, we will be notified and we will submit the correct information for you. The networks review proper licensing, any malpractice claims, provider specialty training and education. The application and approval process can take some time to complete – for example, Medicare and Medicaid typically take up to 120 days and commercial carriers like Aetna and Blue Cross typically take up to 90 days to complete.
Our payer enrollment specialists will follow up on all applications until an effective date is assigned to the health care provider. This signals that the provider has been approved as in-network and claims can now be paid.
Our Relationship With You Is Long-Term
Your relationship with us doesn’t end with your network acceptance. We will continue to keep your data up to date and ensure that any recredentialing applications including CAQH re-attestations are submitted on time. We’ll coordinate with the health plans and make sure they get all new and updated information quickly and accurately.
You’ll see that having a payer enrollment expert like 1st Assistant takes a huge administrative burden off your staff so you can focus on providing excellent health care for your patients!
Let Us Manage All Your Payor Enrollment Services
If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.
Our credentialing experts are here to help you assess exactly which solutions you need and let you know how inexpensively we could put you on the right track. 1ˢᵗ Credentialing includes payor enrollment for all insurance networks including Medicare, Medicaid, Medi-Cal and insurance networks. Don’t wait another minute, contact our terrific team today!