Credentialing and Contracting
We help healthcare providers join insurance networks and get proper approvals. Verifying your qualifications, licenses, and background to ensure you meet the standards of insurance companies and hospitals. Without credentialing, providers cannot bill insurance companies or work with major healthcare networks.
Contracting is the next step, where we help you sign agreements with insurance companies. This process decides your payment rates, terms, and conditions for treating insured patients. A good contract ensures you get paid fairly and on time.
Our team handles the entire process, avoiding delays and mistakes that could affect your practice. Whether you are a new provider or need to update your credentials, we make the process simple and smooth.
Outsourcing Credentialing and Recredentialing to MZ Billing
Credentialing can be complex and time-consuming, but when you outsource it to MZ Medical Billing Services LLC, you gain:
- Credentialing Experts Across Specialties
Whether it’s handling DME enrollments or Medicare group enrollments, we are well-equipped to handle the nuances of credentialing for different specialties, ensuring efficiency and accuracy. - Compliance and Re-Credentialing Support
We proactively track critical deadlines, ensuring timely renewals for medical licenses, DEA certifications, and board certifications. - Streamlined Digital System
We organize all credentialing tasks into a centralized digital system to reduce errors and improve efficiency, freeing up your team to focus on clinical operations. - Quick Turnaround Times
We understand the importance of getting providers credentialed quickly. Our streamlined process ensures minimal delays, allowing new providers to begin offering services promptly.
Our Medical Provider Credentialing Process
Each provider is paired with a dedicated expert who collects all the necessary documents, including Medical License, Board Certifications, malpractice insurance, and DEA/CDS certifications.
We ensure that all information is validated, properly formatted, and submitted to payers such as private insurers, CMS/Medicare, and Medicaid.
Our team actively tracks applications and provides regular updates to resolve any issues, ensuring timely approval.
Once credentialing is approved, providers can start submitting claims for quicker reimbursements and smoother operations.
Our Credentialing & Contracting Services
Tracking Expiration Dates and Renewals
We manage critical documents, such as medical licenses, DEA/CDS certifications, board certifications, and contracts for major health insurance networks like BCBS, Aetna, and Cigna. Our service ensures you stay compliant without additional administrative burden.
CAQH Maintenance and Attestation
Every three months, we update and maintain your CAQH profile, which is essential for CMS/Medicare, Medicaid, and commercial health plans.
Appeals for Panel Closures
Our team actively advocates for your practice, assisting with panel closure appeals to keep your practice in-network and accessible to patients.
Provider’s CV and Demographic Updates
We handle updates to essential information, such as practice locations, provider CVs, and demographic details, ensuring accuracy across all payer systems.
Medicare and Medicaid Enrollments
From individual practitioners to group enrollments, we streamline the processes for getting your practice approved for major insurance programs.
Credentialing for Multiple Specialties
Our team also specializes in niche categories, including Durable Medical Equipment (DME) credentialing and multi-specialty group enrollments.
Benefits of MZ’s Provider Credentialing & Contracting Services
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Faster Approvals – We handle all paperwork correctly to reduce delays and get you approved by insurance companies and hospitals quickly.
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Better Contracts – We negotiate with insurance companies to get you fair payment rates and clear contract terms, so you don’t lose money.
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Less Work for You – Our team manages the entire process, from application to approval, so you can focus on treating patients instead of dealing with forms and emails.
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Avoid Rejections – Mistakes in credentialing can lead to denials or long delays. We check everything carefully to ensure your application is accepted the first time.
Credentialed & Enrolled in Half the Time – Start Today!
FAQS
Frequently Ask Questions.
The NPI is a unique identifier for healthcare providers used in billing, claims, and provider identification across payer networks, ensuring consistency in credentialing and contracting processes.
Services for telehealth providers include ensuring compliance with state-specific licensure requirements, verifying telehealth-specific credentials, assisting with cross-state credentialing for multi-state practice, and managing reimbursement terms specific to telehealth services.
The steps include gathering and submitting necessary documentation (e.g., licenses, malpractice insurance, education), primary source verification (confirming credentials with issuing organizations), background checks, and peer references. After verification, the provider is either approved or denied credentialing based on the results.
Required documents typically include:
Medical or professional license
National Provider Identifier (NPI)
Proof of education and certifications
Employment history (CV or resume)
Malpractice insurance
Background check and reference letters
Payer contracting in healthcare refers to the formal agreement between healthcare providers and insurance companies that outlines reimbursement rates, patient coverage, and the terms under which services will be provided to insured individuals.
