We are hand in hand to understand challenges tied in with provider credentialing and enrollment services. We are committed to providing exceptional services in Texas and across the USA.
About Practice Mate Insurance Credentialing Services
Practice mate is a top rated credentialing company offering comprehensive medical credentialing and provider enrollment services for healthcare practices of all size in Texas, USA. We have highly skilled team of credentialing professionals who understand the requirement of all insurance companies from medicaid, medicare, and private healthcare insurance comapnies.
Each insurance company or program may have specific requirements for credentialing and enrollment, so we do constant monitoring and regular follow-ups to ensure that every step of credentialing is done without any interruption and delays. We have a one-stop solution for all healthcare providers. So, do away with all worries of the daunting task of payer enrollment and provider credentialing that causes unnecessary claim delays and errors.
Our Medical Credentialing Services Include
We are your gateway to optimize revenue and streamline your credentialing process. Our experts are your trusted partner in a hassle and error-free journey.
Medicare and Medicaid Provider Enrollment
We enroll healthcare providers with government beneficiary programs like Medicaid and Medicare. We see the enrollment process in detail by managing primary verification to application preparation till follow-up. Our experts review applications before the submission process. Along with handling your enrollment applications, we focused on DON’T WAIT.
NPI Registration (Type I and Type II)
Practice mate takes you out of troublesome situations by streamlining your registration process for National Provider Identifier (NPI) numbers for both Type I refers individual providers and Type II refers organizations. We enhance billing and claim processing by eradicating the need of multiple providers’ NPI numbers assigned by different payers.
DEA Certificate & Renewal
Drug Enforcement Administration (DEA) certification and renewal is necessary for healthcare providers who manage controlled substances. We are here to provide complete guidance on this certification. We ensure accurate document submission and complete application process for control substances, whether schedule I, schedule II, schedule III, IV, or V.
CLIA Registration
Our expert staff provides complete guidelines on the Clinical Laboratory Improvement Amendments (CLIA) registration process. We ensure all healthcare providers are registered and comply with federal quality standards to offer laboratory testing services.
CAQH Registration and Maintenance
We handle all workflows of your data collection process by ensuring that your profiles comply with CAQH standards and are always up to date. Practice mate verify your CAQH data by ensuring consistency and accuracy. We also assist in quick issues or any discrepancy resolution during the CAQH process by maintaining a profile.
MCR DMEPOS Enrollment
We are here to understand the difficulties of MCR DMEPOS enrollment and assist exempt physicians in navigating this process quickly. Practice Mate provides all-inclusive services, including gathering required documents, application submission, determining exemption eligibility, maintenance, etc. You can assure compliance and reduce your administrative burden by partnering with us.
Reimbursement Issues Audits
Get more revenue-boosting opportunities with our robust reimbursement audit. Our professionals thoroughly analyze your billing data, identify revenue leakage points, and review payer contracts that can directly affect your healthcare practice reimbursement rate. We have detail-oriented recommendations for your practices to minimize potential revenue loss.
Revalidation & Re-credentialing Services
We simplify healthcare providers’ revalidation and re-credentialing process by maintaining active status with payers. Revalidation and re-credentialing help reduce the risk of denied claims and maintain patient safety. We ensure that healthcare providers adhere to the latest regulations with the help of our revalidation and re-credentialing services.
Why Outsource Credentialing Services for your Healthcare Practice?
By outsourcing healthcare credentialing services, you can be assured that your healthcare practice is in professional and expert hands. We will help you to achieve your credentialing goals with any rejections and in timely manner.
Quality and Accuracy Assurance
Our systematic procedures can expedite your credentialing process and provide exceptional accuracy to ensure smooth operations.
Data Security
Our HIPPA Complaint professionals maintain data security (PHI) integrity by employing state of the art EHR software to ensure the utmost privacy.
Single Point of Contact (POC)
Our expert staff of credentialing specialists is dedicated to your healthcare practices. You will have transparent and regular communication with your specialist.
Clear-Cut Tracking & Updates
We are always focused on providing a realistic time frame for your credentialing process. Our credentialing specialists provide you updates as per requirement.
Pocket-Friendly Pricing Options
We provide you with transparent and affordable pricing. We charge you for our services, with no hidden fees. We also offer discounts based on the number of payers.
Experienced Professionals
We have highly trained medical credentialing specialists with over 20 years of experience. Our medical credentialing specialists offer services across all 50 U.S. States
Our Credentialing for Every Medical Specialty
Our credentialing Specialists have in-depth knowledge of unique credentialing requirements and have customized approaches for each specialty.
Family Practice
Orthopedic Surgery
Pediatrics
Psychiatry
Radiology
Surgery
Urology
Internal Medicine
Neurology
Obstetrics/Gynecology
Ophthalmology
Cardiology
Dermatology
Our Medical Provider Credentialing Process (From Application to Approval)
Our provider credentialing process ensures that healthcare providers meet all essential qualifications and competencies to provide high-quality patient care.
Initial Application
We add all details of providers in the application form, including the provider’s certification, training, licensure, malpractice history and other relevant information.
Primary Verification
Our credentialing specialist verifies all details of providers with primary sources of information, i.e. state licensing boards, medical offices, ABMS, ABIM, etc.
Credentialing Committee Review
The Medical Credentialing committee reviews the provider’s application and verifies documents. Providers’ experience, qualification and compliance with applicable standards were also assessed.
Credentialing Decision
Our credentialing specialists notify healthcare providers and simplify the approval process relevant to insurance companies and other healthcare organizations.
Ongoing Monitoring and Re-credentialing
We support healthcare providers in maintaining their credentials through monitoring and avoid any discrepancy caused in healthcare practice.
Faqs
Provider Credentialing Services FAQs
The requirement of a document varies depending upon the type of healthcare providers and insurance companies. Some common documents are listed below:
Credentialing application form completion
Copies of residency certificates and medical diplomas
Immigration status(if applicable)
Experience and work history
Tax Identification Number (TIN)
Certifications and training certificates
The duration of the credentialing process depends upon insurance companies. On average, it takes 3-4 months. Some insurance companies might take a longer time.
Credentialing is much more critical for healthcare providers; without it, providers cannot bill insurance companies for their services. This can impact healthcare practice badly if not done.
Credentialing verifies healthcare providers' qualifications and enrollment to ensure that healthcare provider is added to the insurance company network.