Credentialing
Physician Practice Solutions is a leading provider of credentialing services, a critical process in the healthcare industry.
Credentialing is more than just a formality; it’s about establishing a vital link between physicians and insurance payers. This connection ensures that physicians are recognized by insurance companies, enabling them to provide care to a wider range of patients. By facilitating this link, Physician Practice Solutions helps streamline the administrative process, allowing physicians to focus more on patient care and less on paperwork. This ultimately leads to improved healthcare delivery and patient satisfaction.
Credentialing involves a thorough verification of the qualification of the medical practitioner to ensure they are proficient in delivering the intended healthcare services. Organizations employing foreign healthcare providers may face a more stringent credentialing hurdle. Physician Practice Solutions has developed a system that streamlines the credentialing process to ensure smooth and fast acquisition of the necessary operating documents. Our services help you cut through:
- Regulatory compliance demands
- High cost associated with credentialing.
- Accuracy verification problems
- The lengthy processing time
WHAT ARE THE BENEFITS OF WORKING WITH PHYSICIAN PRACTICE SOLUTIONS FOR CREDENTIALING
With a profound understanding of the intricacies involved, Physician Practice Solutions specialize in navigating the complexities of CAQH profile management with unwavering precision and efficiency. Our dedicated team comprises seasoned professionals who bring a wealth of experience and expertise to the table, ensuring that each CAQH profile under our care is meticulously maintained to the highest standards. From solo practitioners to large healthcare organizations, we cater to providers of all sizes, offering personalized solutions that align with their specific requirements and objectives.
At Physician Practice Solutions, we recognize the significant role that accurate and up-to-date CAQH profiles play in facilitating seamless credentialing processes. As such, we go above and beyond to streamline every aspect of profile management, from initial setup to ongoing maintenance and updates. Our comprehensive suite of services encompasses everything from data entry and verification to document collection and submission, relieving providers of the burden of administrative tasks and allowing them to focus on delivering exceptional patient care.
One of the key pillars of our approach is proactive monitoring and compliance management. Our dedicated team continuously monitors CAQH profiles for any changes or updates required, ensuring that providers remain in full compliance with payer requirements and industry regulations. Whether it’s updating contact information, adding new certifications, or renewing expiring documents, we take a proactive stance to ensure that CAQH profiles remain accurate, complete, and up-to-date at all times.
In today’s fast-paced healthcare environment, efficiency is paramount. Physician Practice Solutions offers a streamlined, hassle-free approach to CAQH profile management, allowing providers to optimize their credentialing processes and enhance operational efficiency. With our comprehensive solutions and unwavering dedication to excellence, we empower providers to thrive in an ever-evolving healthcare landscape, driving better outcomes for patients and providers alike.
Insurance
Do you know insurance payers can decline reimbursement for services rendered by healthcare providers?
During credentialing, insurance payers will verify your physicians’ license, certification, education, and experiences, and dig into their medical practice history to see if they have any malpractice issues. Payers can deny claims for reimburse of services rendered if the provider is not credentialed.
Why you should choose physician practice solutions?
Physician Practice Solutions’ insurance-related experts will expedite your doctors’ medical credentialing process and enroll them in the payer’s network. That gives you access to all the members of the payer’s health plan. This can drastically increase the number of patients showing up in your facility—and your revenue.
If you do not see a specific payer listed, please inquire with us for more details.
Insurance Payers
AARP MCR Supplement
Aetna (all product lines)
Aetna Better Health
Allwell
Ambetter
Brighthealth
Careplus Health Plans
CareSource MCD
Cigna Healthcare
Cigna MCR Advantage
Clear Sping Health
Community Care Plans
Coventry
Devoted Health
Florida Blue (all product lines)
Insurance Payers
Florida True Health
Freedom Health
Friday Health Plans
GHI
Healthcare District
Healthsun
Humana (all product lines)
Humana Tricare
Imagine Health
Medicare
Medicaid
Miami Childrens
MMM MCR Advantage
Molina Health
MultiPlan
Oscar Health
Insurance Payers
Partners Direct
Preferred Care
Prominence
Railroad Medicare
Simply Health Plan
Staywell
Sunshine State
Three Rivers
Tricare East
Tricare West
Unicare Indemnity Plan
Universal Health Care
United Healthcare (all product lines)
UPMC Health Plans
Vivida Health
Wellcare
Insurance Payers
New Century Health (NCH) - ONLY covers Vascular, Interventional Radiology, Cardiology, Oncology & Radiation Oncology medical specialties
NCH Aetna
NCH Avmed
NCH BCBS MCR HMO
NCH Careplus
NCH Coventry
NCH Devoted
NCH Humana
NCH Molina
NCH Simply
NCH Wellcare
Simplify the process and cost of hospital credentialing with physician practice solutions
Hospital credentialing or healthcare credentialing is a legally required process of verifying the qualification of a provider to offer medical services.
Break free from complicated paper works!
The process is stringent, time-consuming, and expensive—but must be done properly to protect the hospital and providers. The process of hospital credentialing requires the verification of a series of documents from the provider and crosschecking them for consistency. In the medical field where legislature is always changing, Physician Practice Solutions ensures that you are always on the good books of the law.
Hospital
Advent Health
Bethesda West
Bethesda East
Broward General
Delray Medical
Hospital
JFK Main
JFK North
Kendall Regional
Lakeside Hospital
Hospital
Northwest Regional
Orlando Health (R)
Oviedo Medical Center
Palm Beach Gardens
Hospital
Palm West Hospital
Select Specialty
St. Cloud Hospital
Wellington Regional
Cut through the complexities of facility credentialing with our expert services
Facility credentialing is just as complex as any other credentialing process. It is the process of evaluation of a facility by a health plan (insurance company) before accepting them in their “network” for the provision of specific healthcare services. If your facility is a freestanding surgery center, home health agency, birthing center, community mental health center, dialysis center and so on, you will need credentialing.
Physician Practice Solutions monitoring the policies and procedures of the healthcare facility, making sure best practices are implemented, and addressing instances in which the hospital does not comply. We figure out creative ways to cut expenses at the facility and improve the quality of care, Creating departmental targets and goals to help staff members enhance the patient.
