Credentialing refers to the process of ensuring if practicing doctors, clinicians, and physicians have undergone the necessary training to practice medicine within a specific city or state. Within the scope of this process, information provided by practicing medical professionals in terms of their
- Career history, and
is thoroughly reviewed before the professional commences a new practice in the same or a different state. BluOne offers credentialing and re-credentialing services for established and new healthcare ventures. We expedite this otherwise tedious and time-consuming process by completing relevant forms within a stipulated timeframe.
A. Provider Credentialing
The process of getting a physician (or provider) connected with the patient so as to enable patients to utilize their insurance cover against medical services consumed during the treatment.
Identified as a critical step in the revenue cycle, Provider Credentialing involves six important steps:
- Provider’s Data: Updating doctor’s information in alignment with relevant policies.
- Payer’s Database: Attach data, label and attach images of the providers in the database of the payer.
- Follow-up: Stay on top of credentialing requests submitted with the authorities.
- Complete Documentation: Source missing documents and update payer’s database.
- Verification: Verify the information provided by the practitioner.
- Analyzing the Application: Find exceptions in the application.