What is Provider Enrollment
When you want to participate in health plan networks to treat insured patients and receive in-network reimbursement, you must go through a credentialing and contracting process with each health plan. This process is referred to as “Provider Enrollment“. The process varies by carrier with some initiating the process with a phone call, others have standard forms to be completed, and some require online credentialing applications be completed. There has been some standardization of the process through CAQH, but the process still requires manual intervention and consistent follow up to ensure it is done correctly and timely.
nCred has developed a standard process for Provider Enrollment that allows its clients to credential once with nCred and then select any number of insurance networks to participate with and have all necessary credentialing information automatically prepared and submitted to desired health plan networks. The nCred process gives its clients the advantage of better turnaround time and access to leading technology throughout the payor credentialing process. Learn more about the nCred process on this page and request a proposal to begin discussing with nCred how our provider enrollment services can improve the efficiency of your organization.
- PAs/ NPs
- Podiatrists (DPM)
- Chiropractors (DC)
- Behavioral Health Providers
- Many More
What provider enrollment and physician credentialing services we provide:
- Commercial Insurance Provider Enrollment and Credentialing (Blue Cross Blue Shield, Anthem, Cigna, Aetna, Humana, United Healthcare, Tricare, and any other plan in the country!)
- Medicare and Medicaid Provider Enrollment and Credentialing
- Medicare and Medicaid Revalidation
- Medicare DMEPOS enrollment for physician groups
- CAQH Registration
- NPI Registration (Type I and Type II)
What you get with our provider enrollment and credentialing service
- An assigned Provider Enrollment Coordinator to act as your advocate with insurance networks
- Additional support staff who maintain your credentialing information and ensure your files are kept current
- Access to the nCred Credentialing system to monitor the status of your credentialing and retrieve information and files. All your credentialing and enrollment information and documents in one central and secured location. Unlimited users for your office staff who need access to your credentialing information
- Paperless intake so that your setup time is minimal thanks to the cloud based nCred Credentialing system
- We complete all credentialing applications and submit all necessary information and documents to your chosen payor networks
- We maintain your CAQH profile
- Follow through with all payors after your credentialing is complete to ensure that your network participation contract is loaded so that you are ready to bill as an in-network provider
- Maintain copies of all your executed contracts in the nCred Credentialing system for your convenient access and monitoring
- Work closely with your billing office or billing company to provide timely information on your effective dates for billing
- Improved turnaround time of your payor provider enrollment applications and contracting process
- Dedicated team to work on your payor provider enrollment process with all the insurance networks
- Access to the nCred Credentialing system to monitor your progress
- Support by experienced staff who work as your advocate with insurance networks to remove the paperwork burden from you
Medicare Provider Enrollment
With the multitude of Medicare Enrollment forms available, nCred can help you identify the correct form(s) and complete the Medicare provider enrollment process to begin accepting Medicare patients in your practice. Whether you are a solo practitioner or a multi provider practice, we can help you enroll new providers, revalidate your existing providers as needed, help with your DME enrollment, and group enrollment records. Call us today at (423) 443-4525 to discuss how nCred can help with your Medicare enrollment needs.
Medicaid Provider Enrollment
State Medicaid plans are often difficult to navigate and determine what is required for provider participation. nCred can help you determine the correct enrollment procedure and complete the process to have your providers in-network with your state Medicaid program. Many states have their Medicaid program managed by commercial networks, in which case you also have to enroll with those Medicaid Managed Care Plans. nCred can assist you with getting in-network with all desired Medicaid Managed Care Plans. Call today at (423) 443-4525 or fill out our request for information form to discuss our services.
The credentialing process for insurance networks varies widely among carriers. All have their own unique forms and procedures for completing the credentialing and contracting process. nCred has helped thousands of healthcare providers throughout the country complete the credentialing and contracting process with thousands of commercial carriers. Our leading technology automatically populates carrier credentialing forms and our experienced staff works as your advocate with carries to ensure your submitted application gets processed. nCred specializes in outpatient medical practice provider enrollment and physician credentialing services and offers the leading solution in the country for these outsourced enrollment services.
Benefits of working with nCred
Monitor your progress
The nCred Credentialing system provides you with real time access to all your information, files, and status of your credentialing applications. Login to review the status of your applications, run reports, and retrieve data.
Focus on patient care
Let us handle the paperwork so that you can focus on patient care and other important operational matters with your medical practice.
We focus on one thing and we do it well. Payor credentialing includes the payor provider enrollment process to get providers credentialed and contracted with health plans important to your practice.
Who can benefit from our services
Solo provider practice or small group practices who do not have dedicated staff members to handle the time consuming tasks of payor enrollment
Mid size to large groups
Larger practices who need technology resources to adequately manage the credentialing information and payor enrollment process for many providers
Hospital owned practices
Hospital or health system owned physician group practices that desire an organized credentialing process with capability of managing the credentialing process for hundreds or thousands of healthcare providers
Billing companies who prefer to focus on reimbursement management and let credentialing professionals focus on the payor enrollment process