Frequently Asked Questions

Contact us today for a personalized quote! Fill out our contact form here or contact us directly via email, phone, or fax.

Phone: (888) 219-4522,  Fax: (888) 202-2837

We understand that all practices are unique. In order to provide you with the best plan for your practice, please contact us today for a personalized quote.

Fill out our contact form here or contact us directly via email, phone, or fax.

Phone: (888) 219-4522,  Fax: (888) 202-2837

Read all about our services here.

Please contact us today to request a personalized quote, and we will be happy to send you all of the paperwork to begin working with your practice. This includes our 3 page provider information form as well as attachments needed. (Attachments may include copies of your license, DEA, malpractice insurance, diplomas, etc.)

It is important to maintain all of your credential information as it changes. In addition, you should reattest your CAQH application every 60-90 days. Insurance companies will typically recredential providers every 18 months.

CREDENTIALING

Credentialing is the verification of a provider’s information to ensure that they meet the criteria outlined in the company’s procedure to become an in network provider. Typically this includes primary source verification of the following; License, DEA, CDS, Medical Education, Training Verification, Malpractice History, etc).

Insurance Credentialing

To become an in-network provider with an insurance carrier, providers must first complete the credentialing process. Each carrier may have different criteria and processes. 

Facility Credentialing 

To have privileges at a facility (hospital, nursing home, dialysis center, etc) providers must complete the credentialing process of each hospital and be approved by their credentialing committee. 

CONTRACTING

The second step to becoming an in-network provider is to contract with the insurance carrier. 

Contract Negotiation

We will review contracts to ensure that they are appropriate for the practice so maximum reimbursement is achieved. 

Our contracting representative’s work with practices to understand their specific needs and make recommendations on additional insurance plans that may benefit the practice. We will negotiate your contracts to ensure the best available reimbursement rates are included. 

Contract Renegotiation

We will renegotiate current contracts of established practices to attempt to increase their current fee schedule. 

How can MDCredentialing Help?

We offer full management of both facility and health plan credentialing and contracting. We complete all applications, submit paperwork and perform necessary follow-up for successful credentialing and contracting. 

We ensure timely submission of all applications. Progress reports are provided electronically on a weekly basis, with phone conferences scheduled at your convenience. 

• New and Established Medical Practices
• New and Established Physicians (MD and DO)
• Nurse Practitioners (NP)
• Physician Assistants (PA)
• Chiropractors (DC)
• Podiatrist (DPM)
• Behavioral Health Professionals
• Physical Therapist 
• Occupational Therapist 
• Optometrist
• Dentist

We can contract and credential your practice and providers. In addition we can suggest plans available in your area and help you with new practice start-up options.

We can help you add additional plans that you may not be currently enrolled with as well as maintain your current information. You should reattest your CAQH application every 60-90 days and insurance companies will require recredentialing every 18 months. 

We can credential and contract your providers as well as maintain your credentialing information. Special attention is needed throughout the credentialing and contracting process and most small practices don’t have a dedicated credentialing employee to manage these issues. 

We can eliminate your need for a credentialing specialist in your practice. The cost associated with having an employee on your payroll includes not only their salary but health insurance, retirement, facilities and equipment. If you already have an employee who is responsible for these duties they can be reassigned to another area of the practice.

Though most academic practices delegate their credentialing at the University level, we can help you with your application for hospital privileges, licensing, DEA, etc.

We can help you apply for your license, DEA, CDS, etc. in your new state of practice. In addition we can help you enroll in the proper insurance plans for your new practice.

We can help you apply for your license, DEA, CDS, etc. in your new state of practice. In addition we can help you enroll in the proper insurance plans for your new practice.

Yes. If you do not have a CAQH ID we can help you obtain one in the credentialing process. We will complete this application for you and ensure that it is correct and submitted correctly to your insurance plans.

Yes. We can help you apply and obtain a group NPI for your new or established practice.

Yes. We can complete your application and follow up with your hospital to ensure that your privileges are granted in a timely manner. 

Yes. We have individual pricing available for providers or practices who want to add additional plans. View our complete list of services here.

Yes. Please contact us today for a personalized quote and we will work with you to identify the best plans for your practice in your area.

We store applications, credentialing worksheets, statements, contracts, CPT codes, reports and other information in an electronic format through optical scanning or other technologies on a secure server.