- (773)-985-1869
- info@stream-rcm.com
- 14430 Ocean Point, El Paso, TX 79938
Stream RCM offers medical credentialing services in the United States to enable physicians, hospitals, and healthcare providers to gain quicker insurance enrollment and maintain compliance. We handle commercial insurance credentialing, re-credentialing, and audits to eliminate delays, and ensure continuous reimbursement while healthcare providers deliver quality patient care.
Provider credentialing is a process of verifying a healthcare provider’s qualifications including education, training, licenses, certifications and work history, to meet payer and regulatory requirements. It is an important step in provider enrollment and medical credentialing that directly impact revenue flow and patient access. We decrease credentialing turnaround time by up to 40%, maintain 98% clean submissions, and support 1,000+ providers across multiple specialties. Our physician credentialing and enrollment services are constructed for accuracy, compliance, and scalability.
We are medical credentialing specialists who provide end-to-end medical insurance credentialing services to hospitals, clinics, group practices and independent providers in the USA. Our medical credentialing services that support all specialties from primary care (Family Medicine, Pediatrics) to surgical specialist (Orthopedics, Neurosurgery) and diagnostic fields (Radiology, Pathology), and subspecialties include Cardiologist, Neurologists and Oncologist. We have combined credentialing specialists, payer workflows, and technologies-based tracking systems as an affordable medical credentialing.
Faster provider onboarding achieved through a streamlined digital credentialing approach.
Higher payer approvals with automated workflows and accuracy-driven credentialing processes.
Significant operational savings by eliminating manual, paper-based credentialing tasks.
Quicker network expansion and fewer enrollment delays through end-to-end credentialing support.
Accurate and compliant healthcare provider credentialing services designed to help achieve timely payer enrollment and continuous reimbursement.
All credits that are time sensitive such as licenses, DEA registrations, board certifications and malpractice insurance are tracked and managed by our service. We track expiration, make reminders, and renewals on time. Compliance and lapse prevention mean that providers are able to concentrate on patient care with a high level of confidence.
We complete the entire credentialing of healthcare providers, which includes checking qualifications, license, CAQH profiles, applications to payers and up to the point of approval. Our team of professionals guarantees proper documentation, submission at the right time and proper coordination with the insurance networks.
We also offer re-credentialing and revalidation solutions which are end-to-end to keep providers engaged in the network. This involves assessment of revised documentations, reapplications to payers and monitoring approvals. We avoid loopholes that might create delays in reimbursement, provider status lost, the practices run without administrative bottlenecks.
Our credentialing solutions are designed individually to providers depending on specialty, payer mix, and size of practice. This comprises recognition of tracking systems, priority schedule as well as individual submission strategies. We activate the credentialing to the specific needs of a provider to minimize errors and facilitate approvals.
Complete, end-to-end credentialing and enrollment services to lessen delays, enhance accuracy and enable providers to take part in Medicare, Medicaid, and commercial payment systems across the country with confidence.
The delivery of end-to-end provider enrollment and credentialing of Medicare, Medicaid, and commercial payers, application management, documentation, and follow-ups, corrections, and approvals facilitate the rapid pace of participation, reduced denials and timely reimbursement preparedness across the country.
Our CAQH profiles are created, updated and managed to ensure correct data, timely attestations, payer compliance, less delays, active medical credentialing visibility and active maintenance to facilitate quick provider enrollments and ongoing medical insurance participation access.
Primary source verification of licenses, education, training, employment and work history is done by our team, credentials are validated directly by issuing bodies to cover regulatory standards and other credentialing requirements under our standards and compliance with the same requirements
We help in payer contracting, negotiation, and coordination, aligning credentialing needs, submission schedules, and participation terms to assist providers to attain compliant agreements, an easier and more desirable approval and better network placement results across the country.
We provide multi-state licensing of telemedicine and multi-location practices, state-specific licensing, payer regulations, licensing schedules, and renewals to increase coverage, ensure compliance, and enable scalable growth strategies among providers across the country.
Our services consist of group credentialing, facility credentialing, organizing provider data, coordination of enrollment, roster management and compliance at all locations to enhance efficiency, accuracy as well as payer involvement in healthcare organizations around the country.
Our team accelerates the credentialing lifecycle through proactive follow-ups and payer-specific submission strategies. Our enrollment and credentialing services reduce delays while maintaining payer compliance and accuracy.
Payer Type
Examples
Standard Time Frame
Our Time Frame
Commercial Payers
Aetna, Cigna, BCBS
90–120 days
45–60 days
Government Payers
Medicare
60–90 days
30–45 days
Medicaid Payers
State Medicaid Plans
90–120 days
45–60 days
Commercial Payers
Aetna, Cigna, UnitedHealthcare, BCBS
Aetna, Cigna, UnitedHealthcare, BCBS
Aetna, Cigna, UnitedHealthcare, BCBS
Commercial Payers
Aetna, Cigna, UnitedHealthcare, BCBS
Aetna, Cigna, UnitedHealthcare, BCBS
Aetna, Cigna, UnitedHealthcare, BCBS
Commercial Payers
Aetna, Cigna, UnitedHealthcare, BCBS
Aetna, Cigna, UnitedHealthcare, BCBS
Aetna, Cigna, UnitedHealthcare, BCBS
New credentialing in medical billing establishes a provider’s initial eligibility with payers, whereas expired credentials can disrupt reimbursements which lead to claim denials, and impact patient access if not addressed promptly.
Your New License Starts Here
Accelerated credentialing programs of urgent provider enrollment requirements, prompt licensing, payer requirements, proper documentation procedures and continuous medical billing functions without pauses, refuses and regulatory retaliation across networks.
145+ Providers license in the last 30 days
Extend Your Current License
Proactive credentialing services take care of license renewals, expirations and payer updates, to ensure that providers are continuously enrolled, comply with insurance standards and participate in all Medicare, Medicaid and commercial payer networks.
75+ License Renewed in the Last 30 days
We deliver specialty-specific medical provider credentialing services aligned with payer and regulatory requirements.
Stream RCM is a preferred hospital credentialing company that is ranked as one of the best outsource medical credentialing companies with effective workflow, payer experience, correct submission, proactive follow-up, open communication, and efficacy on hospital and provider credentialing in the country.
Our credentialing services, which are outsourced, assist healthcare providers to unburden and generate revenue, as well as stay active in-network by handling provider enrollment and credentialing, insurance credentialing, renewals, compliance tracking and payer communications in Medicare, Medicaid and commercial plans across the United States
Our structured credentialing process ensures accurate provider enrollment, faster payer approvals, and ongoing compliance across commercial, government, and Medicaid plans
We provide coding services for skilled nursing facilities, rural health clinics and critical access hospitals, and short-term acute and long-term care hospitals. We also review charges entered by hospital departments
Education, training, licensure, and professional history are verified directly from primary sources to meet payer credentialing standards ensuring regulatory compliance and audit readiness.
We create, update, and manage CAQH and payer-specific profiles to ensure accurate data entry and timely attestations supporting ongoing provider credentialing accuracy compliance.
Credentialing applications are submitted accurately to commercial, Medicare, and Medicaid payers, aligned with enrollment requirements for faster approvals and active participation.
Our team actively follows up with payers, addressing additional requests, corrections, or documentation needs to prevent delays and ensure uninterrupted provider enrollment status.
Once approved, we confirm network participation, organize credentialing records, and track re-credentialing timelines to maintain active status across all contracted payer networks.
Medical billing is the procedure followed in submitting claims to insurance companies in order to get payment for the services offered. It supports the timely payment of healthcare providers while maintaining compliance with the insurance guidelines. Well-organized medical billing procedures are essential in the healthcare sector in order to maintain financial stability while preventing revenue losses.
The denial rate of claims can be reduced by adopting good medical billing procedures because it also assists in preventing difficulties in the execution of administrative processes in the healthcare practices.
Medical coding involves assigning standardized codes to patient care services such as ICD-10, CPT, and HCPCS codes. Medical coding is very critical because it ensures that claims are either accepted or that reimbursement rates are higher. Medical coding inaccuracies often result in denied claims, delayed reimbursement, and even non-compliance issues.
Medical coding ensures that healthcare services are reimbursed to their full potential and also that an organization remains compliant with regulations and regulations to ensure that documentation of services compiled during care can be accepted by insurance firms.
The time taken for compensations depends on the insurer, the integrity of claims, and practice productivity. Generally, clean claims will be processed in 15 to 30 days. When there is an error, claims that are not completed or when there is a denial of claims, it will take longer for claims to be processed. A professional billing service will ensure claims are submitted immediately and there is follow-through on claims that have not been paid to ensure swift payment.
The specialties that we offer our billing and coding services include behavioral health, family practice medicine, gastroenterology, optometry, urgent care medicine, general surgery, and long-term care facilities. Each of these specialties has its own needs and norms when it comes to billing and coding.
The professionals at our company have designed a billing system that addresses these needs and provides our clients with efficient billing and coding solutions. The knowledge that our company has about specialty practice challenges is what our clients need in order to make them successful.
Denied claims are then evaluated to determine why they were denied or rejected, whether due to coding issues, lack of documentation, or eligibility contemplations. Our team then rectifies any issues that may be present and follows through with insurance payers to ensure that denied claims are resolved promptly.
The practice not only reduces costs but also eliminates any delays that may result from denied insurance claims and ensures that there is a smooth flow of income, by being proactive with denied claims
Improve collections, reduce denials, and maintain compliance with proven revenue cycle management services.
