StreamRCM

Credentialing and Contracting

Credentialing is the process of verifying a provider’s qualifications to ensure that they can provide care to patients. Most health insurance companies require this process including CMS/Medicare, Medicaid, and Commercial plans, as well as hospitals and surgery centers.

Unfortunately, medical credentialing can be an unwelcome distraction from providing quality care to patients – but it doesn’t need to be. We’ll take care of that for you!

Credentialing
is a Vital Component

Provider credentialing is a foundational task as practices offering services that cannot be billed are neither feasible nor sustainable for a medical organization.

The credentialing process ensures that the provider meets the required standards of the medical organization and its payers, as well as identifying the risk factors early on to reduce the risk of any adverse outcomes. Not to mention, credentialing is a great way to improve PR to attract new patients and gain their trust.

Although credentialing is time-consuming, it protects your revenues, limits the risk of any potential loss, and enhances your practice’s overall reputation.

Role of Credentialing in
maintaining Standards and accountability

Credentialing is the process of obtaining, verifying, and assessing the qualifications of a healthcare provider who provide patient care services in or for a healthcare entity.

Medical provider credentialing can be time-consuming and difficult to navigate.
It has proven to be a lasting process that will only become more complex over time.
A superior credentialing process reduces headaches for providers, helps organizations, improves patient trust, lowers the risk of medical errors, mitigates the risk of financial loss and penalties, and protects your healthcare organization from potential litigation.

Key factors driving our
successful credentialing procedure

Assign a Credentialing
Coordinator

Allow plenty of Time for the
Credentialing Process

Link a New Provider’s Start Date to the
Submission of Credentialing Forms.

Create a Sustainable
Credentialing Process.

Keep All Physician Contact
Information Up to Date

Thoroughly Understand
Your State’s Regulations.

Our team will be in charge of

Accelerate the Enrollment and
Credentialing Process.

Enrollment Services for Physicians
and Healthcare Entities.

Maintaining the Documents and
Updating the CAQH Profile.

Manage all Payer Communications
and Verifications.

Provide Demographic
Updates.

Get Re-Credentialing/Revalidation
Done on Time.

Sequential tasks in the
Medical Credentialing Process

There are multiple steps in the medical credentialing process

Identification of Required Documents

Prioritize Insurance

Checking for Accurate Information

Wait for Verification

Following Up

Recertification

The advantages of
being Credentialied

To get the best possible reimbursement rates.
To earn the patient’s trust.
To reduce medical errors.
To get more patient referrals from the network

Efficiency

We know what needs to be completed and how to do it. We save your clinic’s staff time and money by completing the credentialing and maintenance that is required.

Experience

Our team has the experience to take care of your credentialing needs and maintenance. You do not want to trust your credentialing needs to someone with less experience!

Expertise

A mistake in the credentialing process or maintenance can be incredibly costly to a practice. Our expertise is necessary for your bottom line.

Transparency

We regularly update your clinic about each application and provide secure, online access for you to see our progress for each application at any time.

Credentialing and Contracting

Simplify credentialing without any hassle

Credentialing and Contracting

Payers for Credentialing

Credentialing
is a Vital Component

Role of Credentialing in
maintaining Standards and accountability