GroupOne Credentialing Services
Credentialing is the process by which the experience and qualifications of physicians and medical practices are evaluated and validated. Typically an objective evaluation that takes into account a practice’s licensing, education and training history, credentialing is critical for providers that wish to become part of a payor network.
Credentialing – You Can’t Afford Not To Have It
Providers must obtain credentialing to become part of a payor network. Without credentialing in place, a practice will be unable to provide care for patients covered by a particular insurance company.
Without complete and proper credentialing, an insurance company may choose to make only a partial claim, requiring the patient to pay the balance.
By fulfilling a critical payor network requirement, credentialing ensures better revenue realization for the provider.
What We Do For You
When you put GroupOne in charge of your organization’s credentialing, you can be sure you’ll get complete, professional and efficient handling of the entire credentialing process, from start to finish.
GroupOne has assisted a wide range of both individual physicians and medical practices with their credentialing needs. Our team of specialists is adept at handling the detailed and sometimes complex requirements that might otherwise delay or even spoil an organization’s credentialing plan.
We take the time-consuming paperwork and phone calls associated with credentialing off your hands, so that you and your team can focus on patient care. We’ll even handle credentialing updates, as and when they’re required.
GroupOne will act as your liaison with payors throughout the process, to ensure that proper credentialing is established and remains in place and on track.
GroupOne Credentialing at a Glance.
The GroupOne credentialing service leverages a simple but highly effective formula to fulfill clients’ credentialing requirements as quickly and cost effectively as possible:
- Clients complete a straightforward but detailed questionnaire describing their practice, including history, licensing information, experience and more.
- Along with the questionnaire, clients provide supporting documentation such as certificates, licenses, etc.
- GroupOne aggregates and reviews the credentialing information, ensuring it is complete and ready for submission.
- GroupOne submits the credentialing package to the payor, and performs all necessary follow-up regarding the credentialing request.
- The practice or provider receives official notification when the credentialing process is completed and approved, after which they may begin seeing patients and submitting claims.
From end-to-end, the process can take up to 120 days; typically it takes between 45-90 days to get credentials.
Don’t waste time with paperwork and phone calls; GroupOne has the experience and can work the credentialing process smoothly and effectively on your behalf.
For more information regarding GroupOne’s credentialing services, call 800-769-5288 or email services@grouponehealthsource.com
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